Year 5 Senior School Taster Day
Please complete this form to register for a place on one of our Year 5 Taster Days. More information about how we will need to process this information can be found on www.cheadlehulmeschool.co.uk/privacy.

Email address *
Please indicate the date you would like your child to take part in a Year 5 Taster Day
Child's Details
Child's surname *
Your answer
Child's first name *
Your answer
Please indicate the name your child would like to be known by *
Your answer
Child's date of birth *
Your answer
Gender *
Required
Child's Address (inc. postcode) *
Your answer
Current School *
Your answer
Parent/Carer Contact Details
Parent/Carer 1 Name (inc. title) *
Your answer
Relationship to child *
Your answer
Parent/Carer 1 email address *
Your answer
Parent/Carer 1 phone number (mobile) *
Your answer
Parent/Carer 2 Name (inc. title)
Your answer
Relationship
Your answer
Parent/Carer 2 email address
Your answer
Parent/Carer 2 phone number (mobile)
Your answer
Additional Information
If your child has a specific learning difficulty, special learning need or disability please provide details
Your answer
If your child has a medical condition, including allergies please provide details
Your answer
If your child has any special dietary requirements, please provide details
Your answer
Please mention any connection with CHS (siblings, Old Wac's, any other family connection to CHS)
Your answer
Declaration
I agree to inform my child's current school of their proposed absence to attend one of our Taster Days.
During the Taster Days we like to take photographs of the children enjoying the activities. These photos are used to record the day and to promote the taster events. If you do not want your child to be photographed, please contact the Admissions Team on 0161 488 3345.
Name of person submitting application form *
Your answer
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