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Pittwater Anglican Church
WAITLIST REGISTRATION
Please complete details for children who attend mainly music:
*
Indicates required field
Child 1 Name
*
First
Last
DOB
*
Enter as DD/MM/YY
Child 2 Name:
*
First
Last
[object Object]
DOB
*
Enter as DD/MM/YY
Child 3 Name:
*
First
Last
DOB
*
Enter as DD/MM/YY
Details about your Family (complete where applicable):
Parent Name
*
First
Last
Phone Number
*
Email
*
For Caregivers
(Please complete where applicable):
Caregiver Name
*
First
Last
Caregiver Phone Number
*
Relationship to child(ren):
*
...
Grandparent
Friend
Aunt/Uncle
Other
Caregiver Email
*
How did you find out about mainly music?
Choose Any
*
Friend/Relative
Website
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