Cirkidz Inc is a registered charity with the Australian Charities And Not-For-Profits Commission. Donations are Tax Deductible. The Cirkidz Community thank you for you donation that will help us to do such things as upgrade our equipment and provide more services to the community. The kids, trainers and staff thank you for your thoughtful contribution to the sustainability of youth arts in South Australia. Please keep your invoice or receipt to claim your Tax Deduction.
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State/Prov: * Postal Code: *
Emergency Contact Info*
Additional Information:
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State/Prov: Postal Code:*