Registration Form Feb 2018 (Earth)
FINALLY we are ready to transform your boys into MEN

Enrol Onto Our Next Programme:
10th Feb 2018 - Information / Registration Day
17th Feb 2018 - Session One (and every week for 6 weeks)

To secure a space for your child on our programme please complete this registration form.

See you at the registration day!

Young Master's Full Name *
Your answer
Young Master's Date of Birth *
MM
/
DD
/
YYYY
Your Address (We will never Share Your Data With anyone) *
Your answer
Name of Parent(s) or Carer(s) Completing This Form *
Your answer
Who Does The Child Live with?
Parent(s) or Carer(s) Email Address *
Your answer
Parent(s) or Carer(s) Contact Number *
Your answer
Medical Details (Name and number of GP) In Case Of An Emergency *
Your answer
Why Do You Want The Manhood Academy To Be Involved With Your Child? *
Your answer
Education Details (Name Of School And Head Of Year) *
Your answer
Main Areas Of Support *
Required
Please Write Some Words About The Main Areas of Support *
Your answer
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