School Holiday Program - Extend
School Holiday Program - Extend
School Holiday Program - Extend
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EXTEND HOLIDAY PROGRAM AT KILVINGTON GRAMMAR SCHOOL (KGS)<br />
BOOKING FORM (ONE PER CHILD)<br />
Complete these steps:<br />
1. ENROL (new families): Complete the Enrolment Form (this can be obtained from extend.com.au or by contacting Head<br />
Office). Please note all existing enrolments will roll-over to the new calendar year until a request is received to<br />
discontinue the account.<br />
2. BOOK: Complete personal details, booking(s), and payment details below and send this signed booking form (one per child)<br />
to <strong>Extend</strong> Head Office: 30-32 Hull St Richmond VIC 3121; Fax: 1300 849 438; Email: enquiries@extend.com.au<br />
3. RECEIVE CONFIRMATION: Confirmation will be sent to your email address within 5 business days of payment being<br />
received. Please note your booking form will only be processed once your child is successfully enrolled with <strong>Extend</strong>.<br />
December bookings close Friday 30 November. January bookings close Monday 17 December.<br />
A $20 fee per child applies for late bookings received after this date.<br />
Personal details<br />
Child’s first name:<br />
Boy/Girl:<br />
Child’s CRN:<br />
Name of school child attends:<br />
Date of Birth: / /<br />
Child’s last name:<br />
Age:<br />
Parent/Guardian first name:<br />
Parent/Guardian last name:<br />
Male/Female:<br />
Parent/Guardian CRN:<br />
Email address (for confirmation):<br />
Parent/Guardian signature:*<br />
Date of Birth: / /<br />
Date: / /<br />
Phone:<br />
Bookings: Tick the relevant date(s) below:<br />
Monday 10 Dec <br />
(<strong>Extend</strong> based $65)<br />
Tuesday 11 Dec <br />
(<strong>Extend</strong> based $65)<br />
Wednesday 12 Dec <br />
(<strong>Extend</strong> based $65)<br />
Thursday 13 Dec <br />
(<strong>Extend</strong> based $65)<br />
Friday 14 Dec <br />
(<strong>Extend</strong> based $65)<br />
Monday 17 Dec <br />
(<strong>Extend</strong> based $65)<br />
Tuesday 18 Dec <br />
(<strong>Extend</strong> based $65)<br />
Wednesday 19 Dec <br />
(Incursion day $75)<br />
Thursday 20 Dec <br />
(<strong>Extend</strong> based $65)<br />
Friday 21 Dec <br />
(<strong>Extend</strong> based $65)<br />
Monday 14 Jan <br />
(Incursion day $75)<br />
Tuesday 15 Jan <br />
(<strong>Extend</strong> based $65)<br />
Wednesday 16 Jan <br />
(<strong>Extend</strong> based $65)<br />
Thursday 17 Jan <br />
(<strong>Extend</strong> based $65)<br />
Friday 18 Jan <br />
(<strong>Extend</strong> based $65)<br />
Monday 21 Jan <br />
(<strong>Extend</strong> based $65)<br />
PUBLIC HOLIDAY<br />
Tuesday 22 Jan <br />
(<strong>Extend</strong> based $65)<br />
Tuesday 29 Jan <br />
(<strong>Extend</strong> based $65)<br />
Wednesday 23 Jan <br />
(Incursion day $75)<br />
Wednesday 30 Jan <br />
(<strong>Extend</strong> based $65)<br />
Thursday 24 Jan <br />
(<strong>Extend</strong> based $65)<br />
Thursday 31 Jan <br />
(<strong>Extend</strong> based $65)<br />
Friday 25 Jan <br />
(<strong>Extend</strong> based $65)<br />
Payment methods: <strong>Holiday</strong> <strong>Program</strong> payments must be made in advance. Accepted payment methods are Mastercard, Visa,<br />
or existing Ezidebit account. Please complete below your method of payment details. Important: If you would like to confirm the<br />
gap payment after fee relief is applied, please contact our office on 1300 366 437 or visit our website for an online calculator. You<br />
will receive an invoice/statement after the payment is processed. Strictly no refunds or cancellations on holiday program bookings.<br />
I authorise <strong>Extend</strong> (Australia) to charge my specified credit card:<br />
Mastercard Visa From existing Ezidebit account <br />
(May take up to 14 days.)<br />
Card number:<br />
Expiry date: /<br />
Name on card:<br />
Amount payable:<br />
Signature:<br />
(Refer to the next page for information on your<br />
out of pocket expense)<br />
PLEASE RETURN THIS FORM WITH PAYMENT DETAILS TO EXTEND HEAD OFFICE:<br />
30-32 Hull Street, Richmond VIC 3121 enquiries@extend.com.au Fax: 1300 849 438 Tel: 1300 366 437<br />
*By signing this form you agree to <strong>Extend</strong>’s enrolment terms & conditions as detailed on the program brochure and website.<br />
For Office use only - KGS<br />
DATE: DB: CONF: EDB:
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