Cinema Day - GRAMS School Holiday Program » Geraldton Regional Aboriginal Medical Service

Children's Name/s

Child 1 Name*

DOB*

Child 2 Name (if applicable)

DOB

Child 3 Name (if applicable)

DOB

Child 4 Name (if applicable)

DOB

Emergency Contact Details

Name*

Phone Number*

Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

By checking the box, I confirm that my children are between the ages of 7-12 and I give consent for them to attend the Cinema Day as part of GRAMS School Holiday Program.*

I Confirm

By checking the box, I give permission for GRAMS to take photographs or videos of my children during the Cinema Day on Wednesday, October 1st 2025. Any photos or videos taken may be used by GRAMS for educational and promotional materials. These photos and videos may be used on GRAMS website and social media platforms.*

I Confirm

What can we help you find?

Cinema Day - GRAMS School Holiday Program

Children's Name/s

Emergency Contact Details

Geraldton Regional Aboriginal Medical Service

Murchison Outreach Service

Carnarvon Gascoyne Outreach Service

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