Child's full name * First Name Last Name Child's Year * Parent / Carer name * Parent / Carer email address * Parent / Carer mobile number * I would like to apply for the CLUBNAME session on DATE TIME at City Junior School. This will be XX sessions and cost XX for the term. * Yes No I understand that if I am offered a place for my child and I do not make payment by the deadline on the email, the place will be withdrawn and reallocated. * Yes Please provide any information on diet, special needs and medical conditions for the child. * Thank you!