Child Registration Form
Little Imaginations Early Years Camp
Child's Full Name
*
First Name
Last Name
Parent's Full Name
*
First Name
Last Name
Email
Full Address
*
Street Address
Street Address Line 2
City
County
Postal Code
Child's Date Of Birth
-
Day
-
Month
Year
Child's School / Nursery
Allergies, Medical Info & Dietary Requirements
Is your child still in nappies? What stage are they at on their potty training journey?
Does your child have an EHCP, or are you in the process of applying for one?
Please give 2 emergency contact numbers
Full Name
Contact Number
1
2
Please provide a list of authorised adults for pick up
Full Name
Who are they to your child?
1
2
3
4
Do you consent for us to put suncream on your child
Yes
No
Do you consent for your child to receive emergency medical care?
Yes
No
Are you ok with photos of your child being used for promotional reasons (including social media)
Yes
No
Please upload a photo of your child (for internal use only)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I hereby declare the information to be true
Continue
Continue
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