Child's Name *

First Name

Last Name

Child's Date of Birth *

PLEASE NOTE AMERICAN SYSTEM SO MONTH FIRST AND DATE SECOND.

MM

DD

YYYY

Emergency Contact Name *

First Name

Last Name

Emergency Contact Mobile Number *

(###)

###

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Membership Fees *

Please tick the payment schedule you would like for your child should they decide to become a member of our evening sessions following their taster sessions, please note this is no obligation

Monthly Single Session (1 per week): £20.00

Monthly Multiple Sessions (2+ per week): £35.00

CONSENT *

From time to time we may take photos and videos to show you what we have been doing or run live sessions. These may be shared on social media.

I Consent

I Do Not Consent