Parent/Carer Name *

First Name

Last Name

Phone number *

(###)

###

####

Secondary phone number *

(###)

###

####

Child Name *

First Name

Last Name

Photo consent

Please tick one of the following options regarding photos/videos of your child. As far as possible we will try to ensure your child does not appear in any photos/videos but we can not guarantee this.

I do not wish photos/videos to be taken of my child.

I am happy for photos/videos to be taken of my child

Second Child Name

First Name

Last Name

Photo consent

Please tick one of the following options regarding photos/videos of your child. As far as possible we will try to ensure your child does not appear in any photos/videos but we can not guarantee this.

I do not wish photos/videos to be taken of my child.

I am happy for photos/videos to be taken of my child

Third Child Name

First Name

Last Name

Photo consent

Please tick one of the following options regarding photos/videos of your child. As far as possible we will try to ensure your child does not appear in any photos/videos but we can not guarantee this.

I do not wish photos/videos to be taken of my child.

I am happy for photos/videos to be taken of my child