Saturday Afternoons - 1.00 pm to 1.30 pm
Web : http://www.xswords.com
Parent or Guardian |
Parent / Guardian (delete as applicable) |
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Title |
Mr / Mrs / Ms / Dr (delete as applicable) |
Forename |
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Surname |
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Child's Name |
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Child's Gender |
Male / Female (delete as applicable) |
Child's Date of Birth |
Day Month Year |
Child's Current Age |
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Child's Handedness |
Left-Handed / Right-Handed (delete as applicable) |
Address |
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Post Code |
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Phone (day time) |
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Phone (evening) |
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Medical conditions of which we should be aware |
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How did you hear about us ? |
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Signature of Parent or Guardian |
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Date |
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Please complete this application form and bring it with your payment (cheque or postal order payable to Brian Riseley) on your next visit to X-Swords Prep-Fencing Club. Applications will be accepted in strict order of receipt of both completed form and payment.