Play Scheme & Football Camp
Full Name of parent
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Phone Number
*
-
Area Code
Phone Number
Email Address
*
Email address
Please select days you would like to book.
Tuesday 26th
Wednesday 27th
Child's Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Are you booking for more than 1 child? If so, please complete details below.
*
YES
NO
Child's Name
First Name
Middle Name
Last Name
Child's Name
First Name
Middle Name
Last Name
Child's Name
First Name
Middle Name
Last Name
Does your child/children have any SEN or Health Needs? If so, please detail here.
*
Do you claim beneift related free school meals
Please Select
Yes
No
My child received school meals not due to benefits
Does your child/children have dietary needs or allergies? If so, please detail here.
*
Are we allowed to administer basic First Aid (plasters, cold compresses)
*
Please Select
Yes
No
Do we have permission to take your child’s photograph?
Please Select
Yes
No
Is your child allowed to go home alone?
*
Please Select
Yes
No
Do you need any additional support?
Any other comments, please use this space.
How did you hear about us?
*
Please Select
Facebook
Instagram
Other Social Media
Newsletter
Poster
Word of Mouth
Signature
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