We meet at: Thirsk Library, Meadowfields 1TH, Chapel St, Thirsk

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Holiday Club 2018

Booking Form

Monday 13th - Friday 17th August 2018

9:30 a.m. - 12:30 p.m


Please fill in the booking form in full or we cannot accept the booking.
All contact information must be given for child safety reasons.
Please call Lydia Stirling on 07837-715294 if you have any questions
Parent/Guardian's Name:
Email Address:
Address:
Telephone Number:
Name of Child:
Gender: Male
Female
Age of Child:
Name of GP:
Any known allergies?
Do you have any Medical/Dietary requirements?
In the unlikely event of illness or accident, I give permission for any appropriate first aid to be given by the nominated first-aider. In an emergency, and if I cannot be contacted, I am willing for my child to be given hospital treatment, including anaesthetic if necessary. I understand that every effort will be made to contact me as soon as possible. Yes
No
Which School to you attend? Thirsk Community Primary School
Sowerby Primary School
All Saints Primary School
Knayton C Of E Primary School
Topcliffe C of E Primary School
South Kilvington Primary School
Carlton Miniott Primary School
Other
Do you consent to pictures or videos being taken of your child, for advertisements, marketing, leaflets, or any other use; such as for training, educational or publicity purposes?

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CONTACT US: Phone: 01609 772868 Mobile: 07974 256379, Email: info@flcthirsk.co.uk | Charity Number: 1129813