Summer Club Contact Form

Once payment has been made, please fill in this form so we are ready for your child to attend the Summer Club!

Child's Name *

First

Last

Age *

Child's Name

First

Last

Age

Child's Name

First

Last

Age

Your Full Name (as on Payment Details) *

First

Middle

Last

Email *

Phone *

Please provide a phone number that can be contacted in case of emergency

Anything else you'd like us to be aware of (disabilities, social anxiety, allergies, etc.)

This information is useful for us to know so we can keep an eye out. We want everyone to feel included and enjoy themselves, so we can pay close attention to those we know who may struggle.

Other comments

Which days would your child/children like to attend? *

Please check all the boxes that your child/children would like to attend. If different children are attending different days, please re-fill the form in.

Can we subscribe you to our weekly worksheets/blogs/videos to boost your child's wellbeing over the Summer?

Yes
No