JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Korean School Language Club
Please complete the form to register your child for Korean Club at Malden Parochial.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Child's name:
*
Your answer
*
Choose
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Please indicate if your child has any medical conditions/allergies and if they require an inhaler and/or auto-injector pen:
*
Your answer
I give consent for club providers to provide first aid when necessary (including administration of inhaler and/or auto-injector pen):
*
Yes
No
Emergency contact 1 (please provide name, relationship to child and mobile number):
*
Your answer
Emergency contact 2 (please provide name, relationship to child and mobile number):
*
Your answer
My child will be picked up by
*
Your answer
I understand that I will need to contact the school office directly if someone different will be collecting my child:
*
Yes
No
I give consent for my child to walk home at 4.30pm once the club has finished (
Year 5/6 children only
):
Yes
No
Clear selection
My child will go to Night Owls after Korean Language club
*
Yes
No
My child will go to Examberry after Korean Language Club:
*
Yes
No
Signed (parent/carer):
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Malden Parochial Church of England Primary School.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report
