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Christ Church Playgroup Highbury
Online Application Form
Name of Child
*
First
Last
Date of Birth
*
Sex
*
Parent(s) / Guardian(s)
*
Home Address
*
Telephone Number
*
Email Address
*
Are you applying for a subsidized place?
*
Yes
No
If your child has documented special medical or social needs, or is a "looked after" child, please provide details:
*
Please provide the name of any sibling who attended the playgroup within the past four years.
*
The playgroup has an equal opportunities policy and is committed to ensuring that its services are known about and used by all members of the community. So that we can monitor this, please state the ethnic origin of your child.
*
Where did you hear about us?
*
I agree to receiving marketing and promotional materials
*
Submit
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