Stage Kids

Primary Contact

First Name*

Last Name*

Relationship to child

Email*

Phone*

How did you hear about us?

Referral Name

Creative/Active Kids Voucher Number (optional)

On the next page you will be asked for your billing information.

The cost of the holiday workshop is A$90.00

Credit card (1.75% + 30c processing fee)

Direct debit (1.00% + 30c processing fee)