Sugar Rats Holiday Camp Form

SUGAR RATS HOLIDAY CAMP

Once you have registered, please make payment into the following account or use the Zapper code:-

Elite Eventures
FNB, Ballito
Branch code: 250102
Acc No: 627 484 734 10

Mother's Name *

First

Last

Mother's Email *

Mother's Contact Number *

Father's Name *

First

Last

Father's Email *

Father's Contact Number *

Child's Name & Surname *

Date of Birth *

Any allergies/meds/food dislikes/quirks we should know

Second Child's Name & Surname

Date of Birth

Any allergies/meds/food dislikes/quirks we should know (copy)

Third Child's Name & Surname

Date of Birth

Any allergies/meds/food dislikes/quirks we should know

Medical Aid Details *

Please provide Medical Aid Name, Number, Plan and Main Member

Next of Kin Name and Phone Number *

In case of Emergency and we cannot get hold of you.

Indemnity *

Notwithstanding any precautions taken, the Elite Eventures & Sugar Rats team, Holla Trails, Verbara Lodge and all surrounding Farmers and Organisers including all volunteers are hereby indemnified and absolved from any claim whatsoever arising from loss or damage to person or property arising from, but not limited to, participation in any activity taking place during the Holiday Camp Event. The use of any equipment, motorised or otherwise, on the premises, and any participation in whatsoever form is hereby deemed to be voluntary and at own risk.

Photos

Please check this box if you DO NOT want photos taken of your child which may be used in social media or advertising

Phone