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Email *
Child's First Name *
Child's Last Name *
Child's Date of Birth *
Parent's First Name *
Parent's Surname *
Address *
Postcode *
Telephone Number *
I would like my child to attend:
(Please tick any of the following options that apply)
Please enter any comments or queries in the space below
Registration Fee £10
Please make a payment of £10 via bank transfer to the following account.

Account Name: Carryduff Pre-School Playgroup
Sort code: 98-00-55
Account Number: 84866034
Reference: Use child's name

Payment due on registration
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