Daycare Form - Roda & Quyen | Little Boomers Basketball

Your Name*
Email*
Mobile*
Which can we help with?*
Child's Name*
What age will your child be turning?*
What dates were you looking at running the party? (you can enter multiple dates)*
Which package are you interested in?*
Which location / venue are you looking to host your child's party at?*
Is there any other message / comments you would like to make about your child's birthday party?*
Your role at the school*
Name of school*
What term were you looking at having us at your school?*
Which program are you interested in for your school?*
How many students are you expecting to participate in the program?*
When is the best time to contact you?*
Choose Your State*
Select Region (NSW)*
Select Region (VICTORIA)*
Select Region (QUEENSLAND)*
What is your postcode:*
Please note that if your child enjoys their trial class, we can't guarantee a spot will be available. We advise enrolling for the term to secure your spot. Select 3 days you are available for a trial class:*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
What is the name of your child's buddy?*
What is their age?*
Please provide your child’s buddy’s contact details so we can check availability. (email or mobile number is fine)*
Which class does your child currently attend? Please include the day and time.*
Consent
I agree to receive marketing and promotional emails from Little Boomers Basketball
Your Message*
Phone
This field is for validation purposes and should be left unchanged.

Daycare Form – Roda & Quyen