Registration Form for friends on the hill

Child's first name: *

Child's surname: *

D.O.B: *

Preferred name:

Student's gender: *

Male

Female

Prefer to self-describe

Is your child currently attending Julian's Primary School?: We currently only accept pupils from JPS' Streatham site. *

Streatham

West Norwood

Neither

School, if Neither please specify:

Class name: *

Is English your child's first language?: *

Yes

Language(s) spoken:

Primary contact first name: *

Surname: *

Relationship: *

Contact number: *

Email address: *

Address: *

100 Cheviot Rd, SE27 0LG

Secondary contact first name:

Surname:

Relationship:

Contact number:

Email address:

Other details:

N/a

Full name of first emergency contact: Please provide two emergency contacts in addition to yourself *

Mobile number: *

Relationship to the child: *

Address: *

Full name of second emergency contact: Please provide two emergency contacts in addition to yourself *

Mobile number: *

Relationship to the child: *

Address: *

I, hereby consent and grant permission to the following persons to collect my child (Must be 18 years or over):

Rosalind G Holbright

Arts & craft club activities: Please select the days of coverage required for your child *

Mondays

Tuesdays

Wednesdays

Thursdays

Proposed date of entry: *

Full name of sibling attending friends on the hill (if applicable):

Please read our Terms & Conditions View T&C's

Any other instructions :

Friends on the hill welcomes applications from parents/guardians of children attending Julians Primary School (Streatham site) aged between 4 and 11 years.

All places are subject to availability. If a place is not immediately available parents have the option of joining the waiting list.

Places are offered on a full time or part time basis.

Priority will be given to siblings of those already attending.

The registration form and parent agreement must be completed prior to the child’s acceptance to attend the club or acceptance onto the waiting list.

Declaration :

I accept the terms and conditions of friends on the hill

Yes No

Full Name of Parent/Carer:

Digital Signature

Rosalind Holbright

Date & time:

26, Aug 2024 07:05 pm

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