AWLQ Animal Care Course Registration

Child's name*

First name	Surname	Age

Please press the + symbol at the end of the row to add additional atendees

Parents name*

First Last

Address*

Street Address Suburb Stare Post code Country

Phone*

Email*

School*

Year level*

Emergency contact name*

First Last

Home phone

Work phone

Mobile*

Is your child currently on medication?*

Yes
No

If yes, please provide details

Does your child have any allergies?*

Yes
No

If yes, please provide details

Does your child have Athsma?*

Yes
No

If yes, please provide details

Any current or pre-existing injuries?*

Yes
No

If yes, please provide details

Is your Child's tetanus vaccination current*

Yes
No

Do your animals have current vaccinations?*

Yes
No
Not applicable

Does your child have any special learning or behavioural needs that we should be aware of?*

Yes
No

If yes, please provide details

Other: Please include any other information regarding medical history or other relevant information should medical attention be required

Please note: Medical information is required in case of an incident requiring first aid or other medical attention. Should your child require medication during their time at the Animal Welfare League of QLD, please ensure that your child is aware of the dosage and how to administer appropriately. Animal Welfare League staff will not be responsible for the administration of any medication.

I give permission for my child to be photographed for AWLQ promtional purposes*

Yes
No

Ticketing

Tickets*

1- ticket - June 1st 2024 Animal Care Course
2- tickets - June 1st 2024 Animal Care Course
3- tickets - June 1st 2024 Animal Care Course
4- tickets -June 1st 2024 Animal Care Course

1 ticket per child for the June 1st Animal Care Course. $70 per ticket.