Child's Name*This field is required. * Required Field. Age*This field is required. Select an Option 5 6 7 8 9 10 11 12 * Required Field. Parent or Guardian Contact Name*This field is required. * Required Field. Parent or Guardian Contact Number*This field is required. * Required Field. OPTIONAL QUESTION: Email Address * Enter a valid email address Photo Consent - I give consent for images to be taken of my child and for these images to be used, modified, and distributed by the Shire of Carnarvon Youth Services.*This field is required. YesNo * Required Field. OPTIONAL QUESTION: Are there any medical conditions or medication requirements we should be aware of? (e.g. food allergies, epilepsy, asthma, diabetes etc.) Type the code from the image: Do not fill this textbox.
