CHILD'S NAME: ............................................................................ AGE: ........

EMERGENCY CONTACT TEL: .................................................................................

EMAIL: .................................................................................................

ADDRESS: ...............................................................................................

ANY MEDICAL CONDITIONS? ................................................................................

Please book Fairy & Pixie Festival 3 Day................(ages 4 - 7)  - I enclose £36 .... (please tick).

Please book Easter Fun 3 Day............................(ages 5 - 9)  - I enclose £36 .... (please tick).

OR - please book BOTH courses AND lunchtime supervision.(ages 5 plus) - I enclose £78 .... (please tick).

(You can book both courses WITHOUT lunchtime supervision if you are taking your child home for lunch.)

Cheques payable to Beverly Marks Stage School. Credit card bookings 01708 438883.

PLEASE PRINT THIS FORM, COMPLETE IT AND HAND IT IN WITH YOUR PAYMENT.