Child registration form Wagga Wagga Name* First Last AgeDate of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920PostcodeAboriginal or TSIAboriginalTorres Strait IslanderBothNeitherYear at School in 2019None selected345678School AttendingParent/Guardian 1 - NameParent/Guardian 1 - Email addressParent/Guardian 1 - Phone numberParent/Guardian 2 - NameParent/Guardian 2 - Email addressParent/Guardian 2 - Phone numberEmergency Contact NamePlease provide an additional (non-parent) contact in case of emergency. Parents will be contacted first.Emergency Contact PhoneAllergy: Please list any known allergies (e.g. medications, food, plants, etc.). If you have experienced an anaphylactic reaction, please detail the cause and severity. Management plans can be emailed to Gondwana Choirs (scc@gondwana.org.au) if necessary.NoneDo you carry an Epipen?Not RelevantYesNoPlease tell us about any other medical conditions (including asthma, diabetes, epilepsy, etc). This information will remain strictly confidential. Please email scc@gondwana.org.au if you have any concerns or to provide management plans.Not applicableDo you have any access requirements? Please give details.NoIs there anything else we should be aware of?NoAre there any court orders in place relating to your family?NoYes