Children First name(s)
Surname Family
eg 07956607645 Emergency phone number will receive txt info about the course please share info.
eg 07956607645 Second Emergency phone number will receive txt info about the course please share info.
M = Male F = Female
What School do they attend?
Medical Details (if any, please fill in the Medical form found on homepage page)
Enter number 1 if attending and leave blank if not.
Enter number 1 if attending and leave blank if not.
Please total £’s & complete payment by Bank Transfer (or CCV’s ) to worldcupsports.co.uk Barclays Sort 20-37-16 Acc. 00054879
I am Paying by
How are you paying.
Childcare Scheme Providers Name or Bank Transfer reference. PLUS Childs name & Venue OF- AY- MH. (Payment due 10 days prior to start) Please put relevant reference here to allow us to match it up to your child’s full name .Orley Farm Setting Reference Number: 2635987 Registration Number 2635986 for Skill & Sports Development.
Full Address please including post code
Photos
Please give permission for us to take photos of your child for our web pages. We will use various pictures from time to time on our website of those who give permission. Or tick No.