Application Form
by Free Rangers
Enrolment Form
| Childs Details | ||||
| First Name | Surname | |||
| Gender | Date of Birth | |||
| Address | ||||
Name by which the child likes to be called
| Parent/Carer Details | ||||
| Title / First Name | ||||
Surname
Home telephone number Mobile number Work number
Session Times
Please tick your desired times (for a full day please tick all relevant boxes in the row for that day)
| 8am-9am | 9am–12pm | 12pm–1pm | 1pm-5pm | 5pm–6pm | |
| Mon | |||||
| Tues | |||||
| Wed | |||||
| Thurs | |||||
| Fri |
Please specify how you found out about us (eg: Google / friends / flyer / etc):
Please enclose a £100 registration fee making cheques payable to Free Rangers.
