Second child's full name (Please supply even if UNDER 18 months)
Your answer
Second child's date of birth (Please supply even if UNDER 18 months)
Your answer
Name of Parent / Guardian *
Your answer
(If the parent above is not the person who will be taking the child to the class, please provide their name and contact details here)
Your answer
Email address *
Your answer
Mobile Tel Number *
Your answer
Would you like to receive messages about classes via "WhatsAPP"? Please note- this will be a Broadcast List- not a Whats App group- so you will not have access to each others numbers through it. *
Address
Your answer
Do you give permission for us to take photographs videos of your children listed above to be used on our facebook / Instagram pages or in other publicity? (we never include their name) You may withdraw your consent at any time. *
Does your child have any allergies or medical conditions that we need to be aware of?
Your answer
If you were taken ill in the class and were unable to look after your child, who could we contact to do so? (Please provide a name and phone number) *
Your answer
Payment *
I have read and agree to abide by the Terms and Conditions. I accept to make payment as stated above and understand the refund policy *
Required
I am happy for you to use my data to contact me and I consent to you contacting me about classes using the information I have provided on this form (Our privacy policy is available to view on our website: www.thephonicsfox.com) *