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Payment information: 27th May - 29th May
Daniel Grannon
Acc No: 22302713
Sc: 404766
First Direct
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Email
*
Your email
Are you a Kirk Deighton Rangers member?
Yes
No
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Which days do you wish you child to attend?
Tuesday 27th May
Thursday 29th May
Option 4
Which days do you wish to sign up for early drop off?
Tuesday 27th May
Thursday 29th May
Which days do you wish to sign up for late pick up?
Tuesday 27th May
Thursday 29th May
How old is your child?
*
Your answer
Child Surname
*
Your answer
Parent Name
*
Your answer
Child First Name
Your answer
Child Gender
Male
Female
Gender diverse
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Home Address
*
Your answer
Phone number
*
Your answer
Emergency Contact Name
*
Your answer
Emergency contact number
*
Your answer
From time to time we would like to take pictures or videos for marketing purposes. Do you give you consent for your child to be included in these pictures and or videos?
*
Yes I give my consent
No thanks, I would rather not
Does your child have any medical conditions that we need to know about?
*
Yes
No
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