Calm Tots' Booking Form
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Parent's Name *
Address (including postcode) *
Email *
Phone number 1 *
Phone number 2
Emergency Contact Name *
Emergency Contact Number *
Relationship to child *
Child's name *
Child's Gender *
Child's Date of Birth *
MM
/
DD
/
YYYY
Does your child have any health issues? *
If yes, please provide details
Does the adult attending the class have any allergies
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If yes please give details
Does your child have any allergies? *
If yes, please provide details
Do you have any specific mobility requirements? *
If yes, please provide details
Is there anything else you would like to make Calm Tots aware of? *
If yes, please provide details
Which classes are you interested in attending? *
Required
Which locations are you interested in?  Classes dates for hall booking TBC *
Required
Which month do you wish to start your course? *
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I consent to photographs being taken during the class which may be used by Calm Tots for any publicity material they wish to present it on. *
I consent to Calm Tots sending me information via email to notify me of courses or services.   You may unsubscribe from these at any point by emailing chris@calmtots.co.uk. *
How did you hear about Calm Tots? *
Confirmation
By submitting this form I confirm the following:

I take full responsibility for the wellbeing and welfare of my child during the class and I will inform the teacher of any changes to the child’s needs or medical conditions before the class commences.

That the information given to Calm Tots is correct to the best of my knowledge and I have read and understood Calm Tots’ terms of business and privacy policy (www.calmtots.co.uk)

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