Days to attend

Please tick all that apply:
4/4/2411/4/2425/7/241/8/248/8/2415/8/2422/8/2429/8/24

Child Information

Child's First Name (required)

Child's Last Name (required)

Age at time of course (required)

Date of Birth (required)

FemaleMalePrefer not to say

Current School

Current Year Group

Parent/Guardian Information

Parent/Guardian Name (required)

Correspondence Address (including postcode)

Telephone (home)

Mobile

Email (required)

Emergency contact name and telephone number (or 'same as above') (required)

Emergency contact name 2 and telephone number (required)

Please give details of any ailments, allergies or other medical physical condition of which the staff should be aware

Please indicate any special dietary requirements

Please indicate your permission below as appropriate (required):

By checking the box below I confirm I am aware that the staff accept no liability for any loss, damage to property or injury arising as a result of my child's participation. I know of no medical reason why my child should not participate. I consent to any emergency medical treatment necessary during the course of the activity session. Completion of this form does not guarantee a place on the course as spaces are limited.

I confirm that I have understood and accept all Terms and Conditions.

Please note your booking won't be finalised until payment has been made.

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