Youth Leadership Academy
Young Engineers Program
Parent's name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
How many children are you planning to register?
*
1
2
3
Name of Child 1
*
First Name
Last Name
Name of Child 2
First Name
Last Name
Name of Child 3
First Name
Last Name
Child 1 age group
*
7-9 yrs
10-12 yrs
13-15 yrs
Child 2 age group
7-9 yrs
10-12 yrs
13-15 yrs
Child 3 age group
7-9 yrs
10-12 yrs
13-15 yrs
Choose your FREE Demo Class for child 1?
*
Saturday, 6th July 11:00 - 12:30pm at Humphrey Community Centre - Urmston
Saturday, 6th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 13th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 20th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 27th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Which activity you would like to register child 2 ?
Saturday, 6th July 11:00 - 12:30pm at Humphrey Community Centre - Urmston
Saturday, 6th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 13th July 1:30 - 3:00 pm Heald Green Village Hall- Cheadle
Saturday, 20th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 27th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Which activity you would like to register child 3?
Saturday, 6th July 11:00 - 12:30pm at Humphrey Community Centre - Urmston
Saturday, 6th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 13th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 20th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
Saturday, 27th July 1:30 - 3:00 pm at Heald Green Village Hall- Cheadle
How did you hear about us?
*
FB Ads
Flyers
Word of mouth
Google search
Community event
Other
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