Girls Youth Club Registration (30/01)
Last Friday of every month - 7pm-9pm @ The Ark Centre
Full Name
*
First Name
Last Name
Date of Birth
*
/
Day
/
Month
Year
Date
Current School
*
CIL Youth Class or WQA Class
*
Please Select
Damascus
Cairo
Istanbul
Fez
WQA
N/A
School Year
*
Please Select
3
4
5
6
7
Medical Conditions
Allergies
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Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Mob Number
*
Email
*
Confirmation Email
example@example.com
Payment
*
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Online Payment
£
2.50
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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