booking form

Parent Name
 
 
Baby Name
 
 
Baby Date of Birth
 
Address
 
 
 
 
 
 
Telephone Number
Home
 
 
Important : please provide a mobile number. This will only be used in case of an emergency on the day of a class.
Mobile
 
 
e-mail address
Important : this will be used to confirm your booking
 
 
 
Class Start Date
 
 
 
Venue
 
 
How did you hear about the course?
 
 
Please advise of any medical problems or other issues which may affect your or your baby’s attendance on this course. Please confirm GP permission if necessary.
 
 
 
SIGNED
 
 
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PARENT/GUARDIAN                                                      DATE
 
Please send your £20 deposit with this form in order to confirm a place on the course.
 
Thank you.