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Lesson Application Form South West London
Lesson Application Form South West London
Parent's Name
*
First
Last
Child's Name
*
First
Last
Child's Date of Birth
*
Day
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Child's Age*
Please enter a number from
4
to
18
.
Child's Year Group At School
*
Child’s School Classname (only necessary if you are applying for a Little Voices After School club)
*
Child's Gender
*
Male
Female
Address
*
Street Address
Address Line 2
City
County
Post Code
Contact Telephone Number
*
Contact Mobile Number
*
Email Address
*
Name of Little Voices centre you are applying for?
*
Are there any medical conditions or medication that your child is taking that we need to be aware of?*
*
Yes
No
Please give details.
*
How did you find out about Little Voices?
A friend or relative
Social media
A newspaper/website ad
A search engine (eg Google)
Another school
Other
Emergency Contact Name
*
Please give a different emergency contact to you.
Emergency Contact Number
*
Please give a different emergency contact number than your own.
When is the best time for us to contact you?
Is there anything else you would like to tell us?
(eg are there any friends that currently attend Little Voices that your child would wish to be in a group with?)
Important Information
*
I consent to Little Voices using my personal data and sensitive data relating to my child for the purposes of organising a lesson and in accordance with the Little Voices terms and conditions and privacy policy.
I confirm that I am the parent / legal guardian for the child named above.
I consent to Little Voices contacting me with news by telephone, email, post and text, newsletters about the lessons, workshops, theatre weeks and events that it runs. I understand that my personal information is not shared outside of Little Voices for 3rd party marketing purposes. Personal data is only used in relation to Little Voices. I understand that I can withdraw my consent at any time by notifying Little Voices.
By submitting this form I give permission for the above named child to attend Little Voices Lesson at the venue and on the dates confirmed once the application is submitted, approved and processed. I accept that any property that is lost or stolen on this date is not the responsibility of Little Voices. I confirm that all the information given is accurate. Little Voices cannot accept responsibility for any inaccurate information provided. I confirm that I will collect my child in person at the end of lesson or inform Little Voices of who will be collecting my child.
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Contact
Principal:
Ashlea Pearson
Telephone:
0208 088 0113
Email Address:
swl@littlevoices.org.uk
Venue
St. Etheldreda Church Hall
528 Fulham Palace Road
Fulham
London
SW6 6JF
AND
St John's Walham Green Primary School
Filmer Rd
Fulham
London
SW6 6AS
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