Summer Camp Application Form 2014
Child's First Name *
Please enter your child's first name
Your answer
Child's Last Name *
Please enter your child's last name
Your answer
Email *
Please enter your Email address
Your answer
Phone number 1 *
Please enter a contact phone number
Your answer
Phone number 2
Please enter a second contact number
Your answer
Any Medical Condition / Medication which may affect your child *
Please specify any medical condition and/or medication which may affect your child's participation
Your answer
Your child's age *
Please enter your child's current age
Your answer
I give permission for my child to be photographed/videoed during the camp *
Please tick
Please Choose the week your child will attendx *
Required
Please Choose your Child's Time *
Required
Have you paid by Paypal? *
Please use Paypal at the top of the page to ensure place
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