Parent/Carers Name:

Email Address:

Contact Number:

Child's Name:

Child's Date of Birth:

Preferred start date:

Days you would like your child to attend: Days you would like your child to attend: Monday 8.30am - 3.30pm Tuesday 8.30am - 3.30pm Wednesday 8.30am - 3.30pm Thursday 8.30am - 3.30pm Friday 8.30am - 3.30pm

Early Starts you would like your child to attend Early Starts you would like your child to attend None Monday 8.15am Tuesday 8.15am Wednesday 8.15am Thursday 8.15am Friday 8.15am

Any other information you would like us to know?

I understand I am required to pay a £25 registration fee which includes a pre school t shirt, changing bag and book bag when my child starts I understand I am required to pay a £25 registration fee which includes a pre school t shirt, changing bag and book bag when my child starts I agree to paying via bank transfer I do not agree to paying the registration fee