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.