Registration Form - Roar Outdoor

Child registration form

Name of person who made the booking *

First

Last

Parent / Guardian name *

First

Last

Dates of attendance

Emergency Contact on the day(s) of attendance *

First

Last

Phone Number *

Child Name 1 *

First

Last

Date of birth *

Child Name 2

First

Last

Date of birth

Child Name 3

First

Last

Date of birth

Child Name 4

First

Last

Date of birth

Any other needs/ Allergies / Medical Conditions

I allow my child to be in photos that may be used for marketing purposes. *