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Payment information:  18th - 21st Aug
Daniel Grannon
Acc No: 22302713
Sc: 404766
First Direct
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Email *
Are you a Kirk Deighton Rangers member?
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Which days do you wish you child to attend?
Which days do you wish to sign up for early drop off?
Which days do you wish to sign up for late pick up?
How old is your child? *
Child Surname *
Parent Name *
Child First Name
Child Gender
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Home Address *
Phone number *
Emergency Contact Name *
Emergency contact number *
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? *
Does your child have any medical conditions that we need to know about? *
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