SárGhael Booking Form
First Name *
Enter your child's first name.
Your answer
Surname *
Enter your child's surname
Your answer
Address *
Please enter where you live
Your answer
Parent's Phone Number *
Please enter both parents' phone numbers
Your answer
Email Address *
Please enter one parent's email address
Your answer
Confirm Email Address *
Your answer
Year/Class *
Please indicate what year/class your child is currently in.
Your answer
Boy or Girl *
Please tick whether you are a boy or girl
Required
Date of Birth *
Please enter two numbers for day, month and year
Your answer
School *
Please indicate where you will be attending school in 2017/18
Your answer
Name of Irish Teacher *
Please indicate the name of your Irish Teacher
Your answer
Name of person to contact if parent cannot be reached (emergency contact) *
Please enter name of relative or next of kin if parent cannot be reached
Your answer
Number of emergency contact *
Please enter the number where we can reach the person of contact if the parent cannot be reached.
Your answer
Please give information on any health issues the student may have.
Indicate any illnesses or health problems the students may suffer from.
Your answer
Please choose course *
Required
Where did you hear about us?
Please state Google, Facebook, Twitter, School or Friend
Your answer
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