Rugby Activity Day - May 18th 2019 God Willing
Age range: Year 1 - Year 6
Speakers: Bro. Dave Godfrey and Bro. Laurence Davenport
Location: Clifton School, Station Rd, Clifton Upon Dunsmore, Rugby CV23 0BT
Time: 10 a.m. - 4 p.m.
Please provide your child with a packed lunch. Drinks and biscuits will be provided.
Cost: £5 per child, £10 per family (pay on the day)
An email will be sent to you to confirm your child's place.
A programme for the day will be emailed to you nearer the date.
If you have any other queries please contact Sis Hannah Jenner: mikeandhan@jennenet.co.uk, 07989804085
Email address *
Child's name *
Your answer
Child's D.O.B. *
MM
/
DD
/
YYYY
Child's Age *
Your answer
Address *
Your answer
Ecclesia *
Your answer
Parent's name *
Your answer
2 emergency contacts - names and phone numbers *
Your answer
Doctor's name, address and phone number *
Your answer
Does the child suffer with allergies? *
If yes, what allergy?
Your answer
Does the child have any dietary requirements? *
In the event of an emergency I agree to the child being given any medical,surgical or dental treatment, including general anaesthetic and blood transfusion as considered necessary by the medical authorities present. *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service