Wild Life Holiday Program ONLINE REGO

Full Name of Participant:
Year @ School:
Mailing Address:
Phone:
Email:
Name of Parent/Guardian
Please indicate the days that the participant will attend Wild Life:		Monday Tuesday Wednesday Thursday Friday

Where did you hear about Wild Life?:		Newspaper Friend (who?) Website Library LCC School George Burnett LC Other

Method of Payment: 1. Cash 2. EFT 3. Credit Card 4. Cheque 5. Other		Payment instructions: 1. Please give cash to Emily or the LCC office 2. Make an Electronic Funds Transfer (EFT) into the Lifestreams Christian Church, South Perth \| All rights reservedGeneral Fund BSB 036 037 ACC 152766 and mark the transaction as WL and the name of the participant (EG. WL Bobby Smith). Then email Emily at emily@spcc.org.au to let her know you've sent the money through. 3. If you want to use a credit card please fill in a hardcopy form or ring Emily. 4. Make cheques payable to Lifestreams Christian Church, South Perth \| All rights reserved 5. If you ticked OTHER you will need to speak to Emily

Any further questions or comments:

Submit Registration

Please note that you will still be required to sign a permission form and complete a medical form.
Any queries please don't hesitate to call on 9313 1600 or email Emily.