@Tap Holiday Care

Durban North Baptist Church

Holiday Care Sign-up form:

* Indicates required field

My Child's Name: *

My Child's Surname: *

Child's Age: *

Please note we cater only for children 3-13 years.

Parent/Guardian's Name & Surname: *

First

Last

Phone Number *

Email *

Additional Emergency Contact *

First

Last

Phone Number *

Relation To Child *

My child is in *

Preschool Gr. 1-3 Gr. 4-7 Other

Name of School: *

What pickup time will you be fetching your child on most of the days? *

Pickup 1 (13:00) Pickup 2 (15:00) Pickup 3 (17:30)

Any Allergies/Medication/Dietary/Special Needs we need to be aware of: *

Which Holiday Care *

23, 25-27 &30 September 5-6 & 9-13 December 6-10 & 13-14 January 2020

Submit

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