Second class - Toddler Kicks Booking Form

Toddler Kicks Booking Form 10:30 - 11:15

Venue - St Werburghs Primary School
PLEASE READ THE TODDLER KICKS INFORMATION BEFORE COMPLETING YOUR BOOKING FORM
Please select correct number of children if booking in more than one
Child's Name

First NameLast Name
Date of Birth
Child's Name 2

First NameLast Name
Date of Birth
Child's Name 3

First NameLast Name
Date of Birth
Address

Street Address

Street Address Line 2

TownCounty

Post Code
Contact Number
Relationship to child
Medical conditions and medication taken
Please select ONE of the following options regarding photographs. These would be used for our website and social media. No children are named:
Any other information you feel we may need -
Email
example@example.com
Form completed by:

First NameLast Name
Signature
Please select the dates you would like your child(ren) to attend. Please ensure you select the correct number of children per day if you have added more than 1 child to the
Categories:All

All
prevnext( X )
Saturday 19th, 26th September / 3rd, 10th, 17th, 24th October

£30.00 Number of children

Total

£0.00
You will receive a confirmation email on completion of your booking. Please email info@amsports.co.uk if you do not receive this within 24 hours.

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Toddler Kicks Booking Form 10:30 - 11:15