Parents Name

Email Address

Home Address

Contact Number

Emergency contact number

Name and DOB of Child Attending

Name and DOB of Child Attending

Name and DOB of Child Attending

What Year Is Your Child In At School?

Who will be collecting your child?

Doctors Name and Address

Please advise if your child has any allergies. Please advise if your child has any allergies. No. Yes.

If yes to the above question please provide further details below. Thank You

Do you know if your child has had an allergic reaction of paints/glue/materials/anything 'arty and crafty'?* Do you know if your child has had an allergic reaction of paints/glue/materials/anything 'arty and crafty'?* No Yes

If yes to the above question please provide further details below. Thank You

Is your child allowed a snack and drink whilst at poponin? Is your child allowed a snack and drink whilst at poponin? Yes No

Does your child require a booster seat? Does your child require a booster seat?NoYes

Costs Costs£18.00 up to 5.00pm£21.00 up to 5.30pm£24.00 up to 6.00pm

What period are you booking for What period are you booking for Full School Term

Which Day/Days of the week would you like your child to visit? Which Day/Days of the week would you like your child to visit? Monday Tuesday

Start Date

End Date

Payment PaymentBacs - Details will be emailed on confirmation of bookingPaypal/Credit Card - A link will be emailed on confirmation of booking

poponin take photos/video for promotional purposes. Are you OK with your child being in photos/video? poponin take photos/video for promotional purposes. Are you OK with your child being in photos/video? Yes No

Would you like to receive the poponin newsletter? Would you like to receive the poponin newsletter? Yes No

Please use this space for any other information you think useful or helpful to the poponin team. Thank You.

Please Confirm Please Confirm I confirm I have read the Terms and Conditions*