Application Form: St John's C of E School

Please print this form out, fill it in and send it to:

Mr. D. J. Whistance
Kilderkin
The Old Malthouse
Nottington
Weymouth
Dorset DT3 4BH

Mr. Whistance,
Please enrol_________________________________
D.O.B.:___/___/___ Age:_____ Male/Female (Please delete)
Address:_________________________________
_________________________________________
_________________________________________
Post Code:____ ____ Tel.no:(_______) ____________
School:___________________________
Any relevant medical information (e.g. asthma):_______________________

Please delete one of the following:

I enclose a cheque for �18 made payable to Mr. Whistance.
I would like to pay weekly (�2 per session)

Insurance cover is only �5 for the term.
Please indicate whether you have enclosed the insurance fee:_____
Signed:__________________________ (Parent/Guardian)
Signed:__________________________ (Young Person)

Your child's gymnastics session will link to their B.A.G.A. level. Please note your child's daily time by ticking the appropriate box. (There are two times for level 4, please choose whichever is appropriate).

4.15-5.15	5.15-6.15
Level 6 (Beginners)	Level 4
Level 5	Level 3
Level 4	Level 2
	Level 1

Please note the meeting dates (all Tuesdays):

1st May 8th May

15th May 22nd May

HALF TERM 5th June

NOT 12th June 19th June

26th June 3rd July

10th July 17th July
If you have any questions please contact Mr. Whistance on (01305) 813237 or e-mail [email protected]

Questions/Comments? E-mail the organiser by clicking this button.

This website designed by Graham Lee

1st May	8th May
15th May	22nd May
HALF TERM	5th June
NOT 12th June	19th June
26th June	3rd July
10th July	17th July