Britannia Village & Royal Wharf School Pick up Service Waiting List 
Hello Parents, 

Please fill out this form to join our waiting list for our after school club pick up service from either Britannia village. 

As apart of this service as requested by parents, we will also offer an optional drop off service back to Britannia village primary school for an additional charge.

Once you filled out this form, a member of our team will be in touch shortly to keep you updated on our date of commencement for this service. 
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Email *
What school does your child/ren attend? *
Please provide your first child's full name. *
Please provide your second child's full name.  (if not required please move onto the next question)
Please provide your third child's full name.  (if not required please move onto the next question)
Please provide your first child's date of birth and age *
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Please provide your second child's date of birth and age (if not required please move onto the next question)
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Please provide your Third child's date of birth and age (if not required please move onto the next question)
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Please provide us with the primary email address of a parent/guardian. *
Is your child registered with us? *
If we require any further information regarding your child, we will be in contact to complete his/hers registration. 
Please provide us with the primary contact name and number? *
Please provide us with the emergency contact name and number? THIS MUST BE DIFFERENT TO THE CONTACT DETAILS ABOVE. 
 *
Has your child got any dietary requirements / allergies ?

If Yes Please List Below (For extreme allergies/dietry requirements, please prepare to send us your child/ren's care plan upon request, this will be the same as your child/ren's school care plan)
 *
Required
Please list any dietary requirements / allergies:

(If none please enter 'n/a')
 *
Does your child have any disabilites and/or medical conditions that require a additional support? Either physically or educationally. 

If Yes Please List Below (If so, please prepare to send us your child/ren's care plan upon request, this will be the same as your child/ren's school care plan)
 *
Required
Please list any additional needs/support:

(If none please enter 'n/a')
 *
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