Minecraft Registration Form 2019
PLEASE NOTE: If dates are not shown this is because they are now fully booked.
Your details will be held securely and not shared with any 3rd party.
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Email address
*
Your email
Dates you would like to book
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Please choose the dates you'd like to book in for
29 July @ St Peter and Pauls
30 July @ St Peter and Pauls
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Child's First Name
*
Your answer
Child's Surname
*
Your answer
Child's Age
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
House Number
*
Your answer
Street Name
*
Your answer
Town
*
Your answer
Postcode
*
Your answer
Parent / Carer Name
*
Your answer
Parent / Carer Mobile Number
*
Your answer
Parent / Carer Home Telephone Number
Your answer
Parent / Carer Email Address
*
Your answer
Emergency Contact Name
*
Additional Person to Parent / Carer
Your answer
Emergency Contact Mobile Number
*
Your answer
Medical Information
*
Please include allergies / medication details
Your answer
Does your child have any learning difficulties?
*
Yes or No
Your answer
If yes, please specify
Your answer
How did you hear about us?
*
Previous customer
Leaflet from school
Leaflet through the door
Online advert (facebook, twitter etc)
Word of mouth
Other:
Photography Consent
*
Do we have your consent to take photographs of your child to be used on the New Ways to Learn website/facebook/twitter to be used for marketing and sharing best practice.
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No
Send me a copy of my responses.
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