Craigburn October 2016 Vac Care

Craigburn Vacation Care October 2016
4th-14th October 2016

15 Murrays Hill Road Flagstaff Hill SA 5159

8270 1620 or 0427 271 768 cps.oshc820@schools.sa.edu.au
Child 1 Full Name *

First Name Last Name
Child 2 Full Name

First Name Last Name
Child 3 Full Name

First Name Last Name
Child 4 Full Name

First Name Last Name
A 2016 OSHC Enrolment form has been completed *

Yes No- Please collect and complete an enrolment form prior to attending Vac Care
Medical details- please specify any medical conditions
Bookings

Week 1

	Child 1	Child 2	Child 3	Child 4
Tuesday 4th- Photography Day
Wednesday 5th- Excursion Noarlunga Leisure Centre
Thursday 6th- Excursion Cockle Train & Natur Playground
Friday 7th Carnival Day

Week 2

	Child 1	Child 2	Child 3	Child 4
Monday 10th Oct- Excursion Movies
Tuesday 11th Oct- Excursion Playground Tour
Wednesday 12th Oct- Disney Day
Thursday 13th Oct- Excursion Adelaide Oval Tour
Friday 14th Oct- Bike, Board & Blade Day

Monday 10th October $5.00 Movie Snack Combo's

Drink Choice

Combo 2- Chip Choice

Combo 3- Chocolate Bar Choice

Parent/Guardian Information
Parent/Guardian 1 Full Name *

First Name Last Name
Phone Number *
Parent/Guardian 2 Full Name

First Name Last Name
Phone Number
Parent Declaration-Please read and answer the following conditions
Illness, Accident & Emergency Authority *

Yes No
Behavior *

Yes No
Late collection fees *

Yes No
Cancellations *

Yes No
Excursion Consent *

Yes No
Community walking Consent *

Yes No
Photograph Consent *

Yes No
Parent/Guardian Signature
I certify that the information entered on this form is true to the best of my knowledge and I undertake to inform the service if any of these details change. *
Signature
Date *
Should be Empty:

Craigburn Vacation Care October 2016