Muswell Hill Course Booking Form Web Site Select Date: * Please select the required date of this course: Yrs 3/4 at 9.30-11.00am on 13th, 15th and 17th August Yrs 5/6 at 11.15-12.45 on 13th, 15th and 17th August Yrs 7/8 at 2.00-3.30pm on 13th, 15th and 17th August Full Name * Telephone Number * Email Address * Full Address (including postcode) Age of child: School year of child: Any dietary requirements: Any allergies or medical conditions: Signed: * Date: * Please make a bacs payment of £69 for your first child and £64 for any siblings to secure your child's place (a/c 12306145 s/c 089103).If you have any queries about this form, or the course, please contact Gayle Creasey on 07941 279177.