Please complete details below and return
with a cheque for the appropriate fee, payable to Lee Mahony, Flat 2, 73
Fisherton Street, Salisbury, SP2 7ST
| Name: | Date of Birth: | |||
| Address: | ||||
| Postcode: | Telephone: | |||
| Does your son/daughter have any medical conditions we should be aware of? | ||||
| Yes/No | ||||
| Dates | Times | Member / Non-member | Please Tick | |
| 10.30am-3.00pm | ||||
| 10.30am-3.00pm | ||||
Signature of
parent/guardian: