CIL Youth 25/26 - Registration Form

CIL Youth Programme 25/26

(If you require a sibling discount code, please register 1st child and then email cil@wycombemosque.com with your request details)
Student Full Name

Only one preferred First NameOnly one preferred Last Name
Age
Date of Birth

DayMonthYear
Gender
School Year from September
Starting in September
School of Attendance from September
Starting in September
Medical Conditions
Food Allergies
Any Special Educations Needs (SEN)
Please provide further information regarding SEN
Has your child attended CIL Youth previously?
Previous CIL Youth class

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CIL Youth Programme 25/26