May 2019 Half Term Fit and Fed Holiday Club Question Title * 1. Which Day(s) would you like to attend? Monday 27th May 2019 Tuesday 28th May 2019 Wednesday 29th May 2019 Thursday 30th May 2019 All 4 days Question Title * 2. Full Name of Child Question Title * 3. Childs Age Question Title * 4. Parent/Guardian Full Name Question Title * 5. Address Address * Address 2 City/Town * Post Code * Phone Number * Question Title * 6. Emergency Contact Name and Number Question Title * 7. Please advise of any medical conditions or disability? Question Title * 8. Consent for photos and videos. These will be used to promote our activities on our various online and offline platforms Yes No Question Title * 9. Consent to administer first aid to your child Yes No Submit