Child's Full Name
Date of Birth
Young Person's Phone Number (if applicable)
Your Email Address
Emergency Contact 1 - Name
Emergency Contact 1 - Phone
Emergency Contact 2 - Name
Emergency Contact 2 - Phone
4-6 years Drama - Mondays 4.00 - 5.00pm
7-11 years Drama Mondays 5.15 - 6.15pm
Incredible Super Heroes - 4-7s - 2nd June - 10am-2pm
Fantastic Mr Fox - 7-11s - 3rd June - 10am-4pm
Do you give Group 64 and our photographer permission to use photographs and video's of your child for promotional purposes such as the website and social media?
If your child has no medical conditions or special educational needs and disabilities please tick this box to confirm this or please make us aware of any SEND, medical condition, medications or particular needs your child may have (including dyslexia so that we are aware for script work), by filling the information in the box below. All information is confidential.
Please take a moment to read our
Terms and Conditions
. By ticking this box I accept that -
4 year olds must be in reception class at school.
I will collect my child on time, if not I will call the office to inform that I will be late.
If we are late, and the front door is shut, I will escort my child around to the side door.
I will pay the membership fee within 2 weeks of the start of term.
I will inform the office if any personal details change.
I confirm that all the information I have given on form is correct.
I have read and agree to these Terms and Conditions
I have read and agree to the Privacy Statement
How did you hear about Group 64?
Please select an option
Word of mouth
Leaflet / poster
Where did you hear about us?