Primo Application Form - Summer 2022 30th Anniversary

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IMPORTANT NOTICE!

Please ensure that the email address you provide is one which you will be able to access between now and the end of the course as email is our usual means of communication.

Email *

Child's surname *

Child's first name *

Gender *

Female

Male

Prefer not to say

Age at start of course *

Please enter in whole years only

Home postcode *

Please enter WITH a space - eg "YO1 1AZ"

Home telephone *

Please enter WITHOUT spaces - eg 01904123456

Emergency telephone *

This should be a number where we can reach you in the event of an emergency during the course.

Home telephone

Other:

Current school *

Health information *

Does your child have any medical or behavioural condition which we may need to know about in order to ensure their safety and well-being during the course? eg. asthma, anxiety, phobia, allergies (including to plasters or other basic first aid treatment). If YES, please give details in the next section of this form.

Yes

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