Privacy Statement

Child Prodigy Ltd is committed to protecting and respecting your privacy and adhere to the Data Protection Act 1998. Any medical details collected is for the purpose of administering first aid, emergency and other medical care, when necessary.

Fields marked with ( ! ) are required.

Registration

Child Information

First name ( ! )

Last name

Age

Date Of Birth

Gender

Sessions (Saturdays- Term time)

Parents Information

Title

First name

Surname

Email ( ! )

Contact numbers: home

Mobile

House no.

Street address

City

County

Post Code

Emergency Contact

Title

First name

Last name

Primary phone number

Relationship to child

Medical Information

Doctor's name

Doctor's phone number

Childhood conditions

If yes please list

Allergies

If yes, please list

Consent

Signature (add your name to confirm)

Date of application

Relationship to child

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