Waiting list

PERSONAL AND CONTACT DETAILS

The personal information on this form will be held securely and will only be shared with teachers or others who need this information in order to meet your specific needs.

Participant name
Date of birth
Gender

Parent/guardian's name

Address

Your Email (required)

Contact number (home)

Contact number (mobile)


I would like to go on the waiting list for the following class/classes

Class
Day
Time

Class
Day
Time

Class
Day
Time

MEDICAL/HEALTH INFORMATION

Please give details of any medical condition or disability/special/additional needs that the club should be aware of *:

Please give details of any allergies:

School

Childcare Voucher Provider


By using this form you agree with the storage and handling of your data by this website.