Paren/Guardian Full Name*:

Phone Number*:

Emergency Contact Name And Phone Number*:

Alternate Pick Up/Drop Off Person and code word:

Email Address*:

Childs Full Name*:

Gender*:
MaleFemalePrefer not to say

Child's date of birth i.e. (01/01/1970)*:

Current Year Group*:
ReceptionYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8

Would you be happy for us to take photos of your child?*:
Blanket YesBlanket NoOnly for publicity purposes

Can your child swim? (Pool is 1.5m deep in the shallow end so unless they can swim or touch the floor comfortably they will need a flotation aid) Please click below to add your child's ability. NO FLOATION DEVICE, IF NEEDED, MEANS NO SWIM.*:

No needs a flotation device provided by meIs smaller than 1.5m but can swim a 20m length (No floation device needed)No but water confident and is taller than 1.5 metres (No floation device needed)Weak swimmer but is taller than 1.5 metres (No floation device needed)Strong swimmer taller than 1.5m (No floation device needed)

Any Medical and Dietary Information. Please note we are a NUT FREE site. If YES please fill in the box below.*:
YesNo