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Registration Form
Student First Name
Student Last Name
Student's Date of Birth
Month
Month
Day
Year
Parent / Carer First Name
*
Parent / Carer Last Name
*
Email
*
Mobile Number
*
Emergency Contact Number
*
Medical conditions we should be made aware of
*
Who will be collecting your child at the end of each session - please provide 2 options
Please provide us with a codeword should someone other than the above be collecting your child.
*
I give my consent that my son / daughter (12yrs old or more) can leave the class without an adult.
*
Yes
No
Not Applicable
I am happy to receive communications via SMS and Email
*
Yes
No
I agree for my child to be photographed in class or at Little Luvvies events and for the photos to be used- only in accordance with our Child Protection Policy
*
Yes
No
Date
Month
Month
Day
Year
I have read and fully understand the following Little Luvvies Health & Safety and Child Protection Policies and the Liability Waiver available via Littleluvvies.co.uk/policies
*
Yes
No
Submit- By Clicking here you agree to the above
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