Please submit this form to register your interest for the holiday camps in April 2012

 

Name of parent/guardian:
Name of child:
Email:
Date of Birth of the child
Mobile contact number:
Telephone number:
Does your child take any medication:
Yes
No
Does your child have any disabilities/special needs?
Any medical conditions (please describe)
Please state whether it is acceptable for pictures of your child to be included in the club's promotional advertising
Please confirm age range
Under 7 year old
7 - 14 year old
   
Acceptance
By clicking here I understand that Brabyns and its employees are not under any liability in respect of personal injury unless neglect can be shown. In the event that my son/daughter is injured whilst participating at Brabyns and I cannot be contacted on the above numbers, I hereby give my consent for my child to receive medical attention.
Enter the code below in here:
 
 
 
Once the form is submitted you will receive an email confirmation of this registration and should you wish to secure the place for your child you will have options to pay online or send a payment via cheque/hand over to one of the coaches.