Free Tuition Form
Year 5-6
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Your Information
Do you consent to your child's photograph being taken and potentially used across promotional material at the year 5-6 tuition sessions? Please enter Y/N. *
First Name and Surname *
Gender *
Date of Birth *
Phone Number *
Home Address and Postcode *
School *
Which day of the week are you registering for? *
Required
Parent/Carer Information
Guardian Full Name *
Relation to You *
Guardian Contact Details (telephone and e-mail address) *
Do you have any special learning needs/disabilities? (if 'Yes', please specify) *
Do you have any dietary requirements/allergies? (if 'Yes', please specify) *
Equal Opportunities
What is your ethnicity? Please choose one box. *
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