Gender: *

Ethnic Origin *

The students email and the parents email should be different!

What Year group is your child in? *

Date of Birth: *

Mode of Transport

Where does the student currently go to School

Do you wish to register multiple children in one go?

First Name

Second Name

Birthday

Year Group

Gender

Email Address

Is your child normally healthy?

Has your child had any of the following?

Priority Contact 1...


Priority Contact 2

Do you give permission for your child to take part in local vists such as those to local parks / museums

-

We may use digital media including photography and video. We have a 100% safe use of images and digital media policy and follow national guidelines. Such media may be used in newsletters, on the website or local authority. Please see Section 5 of our Safeguarding Policy for further information. Having read the above do you give consent for digital media to be used by the Academy?


By signing your name you hereby confirm that the information contained in this registration form is true to the best of your knowledge and belief and you agree to our terms and conditions.

How did you hear About Us? *

Do you wish to book a free trial session now?


Tier

Subject

Centre

Day

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