Expression of Interest

Child’s Given Name*
Child’s Surname*
Child's Date of Birth*
MM slash DD slash YYYY
Parent/Guardian’s Full Name*
Parent/Guardian’s Address
Post Code
Telephone Number*
Email Address*
Number of days per week to attend*
Location*
Preferred Days*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Date to commence*
MM slash DD slash YYYY
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