Movers & Makers C.I.C Registration Form
October half term inclusive camp 2019
Dates: 21st - 25th October, 2019
Times: 09.30am - 15.30pm
Fee: £35 per day per child aged 6-12 years

Information provided on this form will be used for each child's care plan.
Which dates would you like to book for the October half term inclusive camp 2019: *
Required
Child's Full Name *
Your answer
Preferred Name
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Parent/Carer Name *
Your answer
Email address *
Your answer
Home address *
Your answer
Telephone numbers *
Your answer
Emergency contact numbers *
Your answer
GP Name, address and telephone number *
Your answer
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