You can always press Enter⏎ to continue
Breakfast Club
Please complete this form to book your child in to Breakfast Club
5
Questions
START
1
Your Child's / Children's Name
*
This field is required.
For more than one child, enter all their names here. E.g. John, Michael and Carly Smith
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Your Child's / Children's Class
*
This field is required.
Class 1
Class 2
Class 3
Class 4
Previous
Next
Submit
Press
Enter
3
My child / children would like to attend breakfast club regularly on ...
*
This field is required.
Please tick the days that you would your child to
regularly
attend breakfast club.
Monday
Tuesday
Wednesday
Thursday
Friday
Previous
Next
Submit
Press
Enter
4
Please list any food allergies, medicines or medical conditions that your child has, that you would like us to be aware of.
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
5
Signature
*
This field is required.
By signing, I agree that my child / children will attend the breakfast club on the days that I have selected. I will adhere to the Covid-19 restrictions that the school has put into place. I also acknowledge that the school reserves the right to cancel the breakfast club in light of changes in guidance from UKGov.
Clear
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
5
See All
Go Back
Submit