Registration Form

Registration Form - To be filled by adult

Please note: A separate form is required for each child you wish to register.

Child 1 full name:

Date of birth:

Day

Month

Year

Home address:

Medical & Health Information - Doctor’s Name & Surgery:

Medical Conditions - (mark N/A if child has none):

Allergies/Dietary Needs (mark N/A if child has none):

Medication (if applicable):

Special Educational Needs / Additional Needs - Please specify:

Parent/Carer First name:

Parent/Carer Last name:

Email:

Primary Phone:

Secondary Phone Number

Relationship to Child:

Please specify here if you have chosen 'other'

Emergency Contacts (other than parent/carer):

Please insert name and contact number for your emergency contact.

If you experience any difficulties filling out the registration form online, please don’t worry — a member of staff will be available to support you step by step.