11+ Group Classes

Parent Name *

First Name

Last Name

Student Name *

First Name

Last Name

Does your child have any medical needs or conditions? *

Yes, please give details below

No

Name *

First Name

Last Name

Name *

First Name

Last Name

I give permission for my child's photograph to be taken for marketing purposes *

Photographs/ videos will be taken during the course, however your child's face will only be included with your consent. Your child's name will never be used in conjunction with their photograph

I agree

I do not agree

Session Times *

Select the session you would like your child to join.

Monday 3:45-5:15pm

Wednesday 3:45-5:15pm