Koorie Homework Club Registration Form

Student Details
Parent/Guardian Details
Home Address
I give permission for my child/children to receive medical treatment in the event of an emergency *
I give permission for photographs, film, tape and recordings to be taken of my children and for their use in promotional materials. *

Privacy Statement: The information on this form is being collected for the purposes of enrolling the student/s in the Koorie Homework Club, and being able to contact parents /guardians.

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