Complete the form below to become a member of the HUNGRY JACK’S® KIDS CLUB. Your name will then be entered onto our special membership roll. And on your birthday you will receive your membership card and your special birthday card. Being a member of HUNGRY JACK’S® KIDS CLUB is great fun, because you will get special free treats, not just on your birthday, but all through the year.

First Name:		Surname:
Street:		Street (Line 2):
Suburb:		State: ACT NSW NT QLD SA TAS VIC WA
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Date of Birth: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year
Parent Details
Mr Mrs Ms Firstname:		Surname: