Activities Registration

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Half Term Activities, Registration Form

* Indicates required field

Parent/Carer Name *

First

Last

Phone Number *

Parent/Carer Contact Email Address *

Address *

Line 1

Line 2

City

State

Zip Code

Country

First Child Name (£15.00) *

First

Last

08:30 Early Start @ £3.00? *

Yes No

Second Sibling (£12.00) *

First

Last

08:30 Early Start @ £3.00? *

Yes No

Third Sibling (£12.00) *

First

Last

08:30 Early Start @ £3.00? *

Yes No

Age of Child 1 *

Age of Child 2 *

Age of Child 3 *

Dates *

Monday 8th April Tuesday 9th April Wednesday 10th April Monday 15th April Tuesday 16th April Wednesday 17th April

Please use the comments box below to let us know if they have any special dietary requirements that would affect their lunch. We also ask that you tell us if your child has any major medical problems that you feel we should know about.

Comment *

I confirm that I allow Debenham Sports and Leisure to hold my details appropriately and contact me with information on future events. *

.

Submit

Debenham Sports and Leisure Centre, Gracechurch Street, IP14 6BL.

Tel: 01728 861101

Home
The Deben Lounge Bar
Membership
Sports
Fitness
- Fitness Studio
- Regular Activities >
Events
Groups
- KIDS GROUPS >
- ADULTS GROUPS >
Active Wellbeing
Community Centre & Function Rooms