Wychwood Inspires
Booking Form
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I can..... Science
Age: 8 - 11
£
300.00
Dates
28th October - 1st November
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Parent/Guardian Details
Name
*
First Name
Last Name
Email Address
*
Relationship to Child
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Please Select
Parent
Guardian
Carer
Other (please detail)
Other:
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Daytime Phone Number
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Please enter a valid phone number.
Format: 000000000000.
Emergency Contact Phone Number
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Please enter a valid phone number.
Format: 00000000000.
Additional Phone Number (optional)
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Format: 0.
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Child Details
Please note we can only accept one child per booking. To book more than one child please complete a separate booking.
Name
*
First Name
Last Name
Date of Birth
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Please select a day
1
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Day
Please select a month
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Month
Please select a year
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Year
What School does your child attend?
Does your child have any medical conditions or requirements we will need to be aware of?
*
Please provide as much information as possible
Will your child be bringing medication with them?
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No
Yes
If "Yes" please give details of medication and administration
Does your child have any known allergies?
No
Yes
If "yes" please give details including the allergen(s), symptoms and any medication (e.g. adrenaline autoinjector (EpiPen) or Piriton)?
Does your child have any dietary requirements or food intolerances we need to be aware of?
*
Does your child have any behavioural or special educational need that we would need to be aware of?
If "yes" please provide further information
Child's First Language
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English Language Level:
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First Language
A1 Elementary
A2 Lower Intermediate
B1 Intermediate
B2 Upper Intermediate
C1 Advanced
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How did you find out about our courses?
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I am a parent/guardian of a Wychwood Pupil
Wychwood School Website
Wychwood Weekly
School Instagram Account
LinkedIn
Banner Advertisement outside the school
Facebook/Instagram advert
Oxfordshire Living Magazine
Oxford Mail Advert
Other
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Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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