Please complete a separate order form for each child that you are ordering ID Cards for.   Your Name: * E-mail Address: * Contact Name & Phone Number: * Delivery Address: * Attach Colour Photo here (1 child only in photo - head + shoulder shot), NO face paint, sun glasses or hats on the child please. .jpg format: Childs First Name: * Childs Middle Name: * Childs Surname: * Parent or Guardians Names: * Street Address: * Suburb * State: * NSW QLD VIC TAS NT SA WA ACT Post Code: * Country: * Home Phone # * Mothers / Guardians Mobile #: * Mothers / Guardians Work #: * Fathers / Guardians Mobile #: * Fathers / Guardians Work #: * Childs Date of Birth (dd/mm/yyyy): * Childs Height (feet and inches or centimetres): * Childs Weight (pounds or kilograms): * Childs Gender: * Male Female Childs Hair Colour: * Blonde Black Brown Red Grey Auburn Childs Eye Colour: * Green Brown Blue Grey Hazel Race: * Caucasian Asian Middle Eastern Aboriginal Torres Strait Islander Black Pacific Islander Other If other please specify: Childs Blood Type (if known): * A + A - B + B - AB + AB - O + O - UNKNOWN Dentists Name & Phone #: Doctors Name & Phone #: Comments (i.e. identifying marks) * Medical Conditions: * Medications: * Allergies: * First Spoken Language * Special Instructions (i.e. if you prefer to leave something off the card, let me know here): ID Card - $14.95 each - per child: * 1 Card 0 Cards Additional Cards - $7.48ea. (3 cards or more) - per child (must use the same name as first card): 0 Additional Cards 3 Additional Cards 4 Additional Cards 5 Additional Cards 6 Additional Cards Complete Set - $37.90 per set (1 card + 1 ID-Inside Wristband), Your choice of colour Vital-ID or Medical ID Wristband. BONUS: FREE Lanyard + card holder) 1 Complete Set (1 card, 1 ID Wristband, 1 Lanyard + 1 Card Holder) 2 Complete Sets (1 card, 1 ID Wristband, 1 Lanyard + 1 Card Holder) 3 Complete Sets (1 card, 1 ID Wristband, 1 Lanyard + 1 Card Holder) Charcoal Wristband Green Camo Wristband Pink Camo Wristband Pink Wristband Blue Wristband Orange Wristband Child size wristband - fits approx. 2-9 Yrs Youth size wristband - fits approx. 10-15 yrs How did you hear about ID Your Child?: Word of mouth Web Search Newspaper / Magazine Friend Childcare / School On-Line Forum Other If other - please specify: Verification Code: Enter Verification Code: * * Required

© 2007 - ID YOUR CHILD / ABN: 93-788-968-302
 

  All Kinds of Info