Adventurer Registration 2021

This registration form is to be filled out per person.

What classes do you wish to join?
Any known medical condition
Allergies to
Anaphylaxis / Asthma
Any disability or impairment?
To be completed by Parent / Guardian
I am willing to assist Mile End Adventurer Club in (WWCC number is required)
Emergency Contact
Declaration
I give permission to use photos of my child for promoting and reporting purposes.
Registration Fee
I accept to paying the registration fee of
A
Place to
   belong

1300 480 763

info@mileend.org.au

320 Annangrove Road

Rouse Hill, NSW 2155

Venue is located to the rear
of the Industrial Building.

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@2021 Mile End Community Church