Club Create registration form '22-23
New Starter form
Child 1
Name
Age
Child 2
Name
Age
Parents Details
First Name
Last Name
Email
*
example@example.com
Phone number
*
Please enter the best number to contact you on in case of an emergency
Address
*
Door number
Street Address
City
Postcode
What days will your child be attending
*
Mondays
Thursdays
Do you require school pick up?
*
Yes- from Sefton Park
Yes - from Brunel Field
No - my child will be dropped to the venue for 4pm
Child's class name & year group
*
type N/A if pick up not required
Clear directions to classroom /pick up location
*
type N/A if pick up not required
Any medical / allergy information? please also include any medication your child needs during their time with us and any instructions for use
I will notify Shout Out! via Email (or text if the same day) if my child has not attended school / or does not need picking for any reason.
*
I agree
Do you consent to photos/videos being taken of your child for documenting the classes or promotional material?
*
Yes
No
I understand that the sessions are booked in termly blocks and my child's place will need to be renewed each term
*
I understand
Submit
Should be Empty: