Easter Club Registration Form

Easter Club

Student Registration Form
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Parent Email*
example@example.com
Parent / Carer Name
Contact Number
Permission for photographs and videos to be used on social media and advertising

YesNo
Medical Needs and Allergies
Should be Empty: