Cardinia Shire Council Youth Services
Booking form Winter2018 – Teenage school holiday program
Participants name: / ______Bookings and payment: (Parent/Guardian MUST sign form). Bookings and payments can be made online at in person by cash, cheque or credit card at:
- My Place 5–7 Main Street, Pakenham. (Please note – no cash is held at this facility therefore no change can be given)
- Email consent and booking form to u will then be contacted via phone for any payments via credit card details.
Bookings for all activities are limited and not guaranteed. You must tick the box next to each activity you choose and where the participant will be getting on and off the bus. Refundswill only be given if a medical certificate is supplied, or the activity is cancelled due to insufficient numbers, extreme weather or other extenuating circumstances at the discretion of Cardinia Shire Council.For more information contact My Place on 1800 496 884 or email
Week 1: Tuesday 3 July – Friday 6 July
Date / Activity / Bus pickup: Please tick where young person will be getting on and off the bus () / Cost / () Tick attending / Amount payableTuesday 3 July / Cake baking -
BOOKED OUT / N/A / $5
Archery Attack / ? Nar Nar Goon ? ?? Garfield ?? Meet there / $10
Wednesday 4 July / Cake decorating -BOOKED OUT / N/A / Free / N/A
Silent disco - CANCELLED / ? Koo Wee Rup ?? Meet there / Free / N/A
Thursday 5 July / T-Shirt printing / N/A / $5
Lino printing / N/A / Free / N/A
Friday 6 July / AFL / ? My Place ?? Beaconsfield / $10
Week 2: Tuesday 10 July – Friday 13 July
Date / Activity / Bus pickup: Please tick where young person will be getting on and off the bus () / Cost / () Tick attending / Amount payableTuesday 10 July / Resin Art –
BOOKED OUT / N/A / Free / N/A
Art Class / ? Nar Nar Goon ?? Garfield ?? Meet there / Free / N/A
Wednesday 11 July / Lake Mountain / ? My Place ? / $50
Hip hop class / ? Koo Wee Rup ?? My Place ? / Free / N/A
Thursday 12 July / Ten pin bowling / ? My Place ? / $10
Virtual reality / ? Gembrook ?? Cockatoo / Free / N/A
Friday 13 July / Library Lock-in / N/A / Free / N/A
Total payable: / $
?I am aware of the expectation that sunscreen must be worn when participating in outdoor activities.
Sunscreen will be supplied by Youth Services and offered throughout the duration of the activity (more
frequently during water activities).
Parent signature: ………………………………………………………………….Date: ……………………………………….
Customer Service use: / Receipt no: / Amount: $ / Date:Youth Services use: / Tick box when entered on booking system