Name of Child: Date of Birth: Age of Child on 1st September 2017 Home Address: Postcode: Height: School Address: _________________ FT _________________ Inches School Year Parents name and contact: Email Address: Name: Home: Mobile: All correspondence will be via email so please Work: check regularly and inform of us of any changes. Any additional/medical needs: Do you attend dance/drama school or classes? NO YES If yes please give name: Education Authority: Please fix two identical passport photographs here. This is who you pay your council tax to, please delete as appropriate: Liverpool Sefton Knowsley Wirral Halton Wigan St Helens Warrington Cheshire West Cheshire East Lancashire Other: (please specify): __________________________________________ OFFICE USE ONLY: RED Blue Reserve
Name of Child: Date of Birth: Age of Child on 1st September 2017 Home Address: Postcode: Height: _________________ FT _________________ Inches School Address: School Year Parents name and contact: Name: Home: Mobile: Work: Email Address: All correspondence will be via email so please check regularly and inform of us of any changes. Any additional/medical needs: Do you attend dance/drama school or classes? NO YES If yes please give name: Education Authority: This is who you pay your council tax to, please delete as appropriate: Liverpool Sefton Knowsley Wirral Halton Wigan St Helens Warrington Cheshire West Cheshire East Lancashire Other: (please specify): __________________________________________ Please fix two identical passport photographs here. OFFICE USE ONLY: RED Blue Reserve
37869_full.docx