PARENT / GUARDIAN NAME
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Email
*
example@example.com
Child Name
*
First Name
Last Name
CHILD AGE
*
CHILD Date of Birth
*
-
Month
-
Day
Year
Date
ALLERGIES
*
Please Select
NO KNOWN ALLERGIES
MY CHILD HAS ALLERGIES (Please note them below)
PLEASE TELL US ABOUT YOUR CHILDS ALLERGIES?
DOES YOUR CHILDS HAVE ADDITIONAL NEEDS?
*
Please Select
NO
YES
PLEASE TELL US ABOUT YOUR CHILDS ADDITIONAL NEEDS?
CAN YOUR CHILD BE ON SOCIAL MEDIA?
*
Please Select
YES
NO
SELECT YOUR CAMP DATES (for full week with a discount, please select the last option)
*
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( X )
7th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
8th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
9th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
10th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
FULL WEEK - 7th to 10th April
£
70.00
Quantity
1
2
3
4
5
6
7
8
9
10
14th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
15th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
16th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
17th April 2025
£
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
FULL WEEK - 14th to 17th April
£
70.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
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Card Expiration
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