Holiday Club Booking FormPlease complete this form for each child attending State which club you are booking for: Child's Name * First Name Last Name Primary Carer's Name * First Name Last Name Relationship to child * Primary Carer's Email * Primary Carer's Home Phone Number Primary Carer's Mobile Number * For Emergency Contact Second Carer's Name * First Name Last Name Second Carer's Mobile Number * For Emergency Contact Any medical needs or medication required? * Yes None If Yes please provide details here: Any special dietary requirements? Permission to publish photographs of your child * Please tick all boxes that apply: I'm happy for STEAMLabs to use photographs of my child: In STEAMLabs publicity In displays of children's work In collaborating organisation's publicity Please DO NOT publish any photos of my child Does your child have any special needs? * Yes No If yes please give details and contact STEAMLabs for more information Thank you - you will now be redirected to the payments page!
