PRINT AND BRING TO SESSION WITH FEES 

 Registration Form

Childs Name

 

 

Address

 

 

Home Telephone Number

 

Childs Mobile Number (if applicable)

 

Date of Birth

 

Age

 

 

Parent / Guardian Details

Name

 

Work Address

 

Work Telephone Number

 

Mobile Number

 

Email Address

 

Next of Kin

(in case of emergencies)

 

Relationship to Child

 

 

Contact Number

(in case of emergencies)

 

Does the child have any allergies?  

Please list

 

 

 

Is your child allowed to make their own way home at the end of the session? YES / NO

(Applicable to older children only)

 

  Signed …………………………………………………                    Date   …………………………

Parent/Guardian

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