Register – Holiday Club – Fairlop

Apply for Admission

Child's Full Name (Required)

Child's Date of Birth (Required)

Current Age (Required)

Gender (Required)

School (Required)

Class (Required)

Parent/Carer Full Name (Required)

Relationship to Child (Required)

Parent/Carer Email (Required)

Phone Number (Home)

Phone Number (Mobile)

Emergency Contact 1 Full Name (Required)

Emergency Contact 1 Relationship

Emergency Contact 1 Phone Number

Child’s Doctor Name

Doctor’s Phone Number

Does your child have any allergies?

Consent for Outing

Consent for Photos/Videos