Child Registration

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Code

School Name

Club Name

First Name of Child *

Surname of Child *

Date of Birth (DD/MM/YYYY)

Medical History/Notes

First Name of Parent

Surname of Parent

Mobile/Emergency Number *

Email Address *

Address

I acknowledge that I have read, understood and agree to the terms and conditions published by Energy Kidz Ltd.

I am happy for Energy Kidz Ltd and their recommended partners to contact me with news, information, special offers and promotions that might be of interest.

Terms and Conditions

School Club Registration Form

To secure your child a place in a school club, please enter the unique club code, found on your letter or leaflet: