Date's Attending *

Wed 2nd July, 9am - 12pm (Day 1)

Thu 3rd July, 9am - 12pm (Day 2)

Fri 4th July, 9am - 12pm (Day 3)

Sun 6th July, 10am - 12:30pm (Family Fun Day)

Child's Name *

To register another child, please complete another form.

First Name

Last Name

Parent/Guardian's Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

By completing this form, you give permission to APC & Quiz Worx to take photos of your child during the Holiday Kids Club Event for promotional purposes.

If you do not wish for your child to be photographed during the Holiday Kids Club event, please opt out by checking the box below.

No photos please