Active FundaysThursday 28 May 11am - 2pm | £3

A wide range of sporty activities including trampolining, fun games, SHOKK Gym & dance mats and creative arts session. BRING A PACK LUNCH

PG Sports Football Sessions at St Mary’sTuesday 26 May - Friday 29 May 10am -12noon | £3

Contact Football Phil on 07979683999

Fun Games, Shokk Gym, Xbox Games and Dance MatsTuesday 26 May | 1pm - 3pm | £2

Suitable for 5-11 years.

12

3

Weekly After School SessionsTuesdays - Boxer Circuit 4.45pm-5.45pm | £3.20 | 5-15 years

Wednesdays - Trampolining 4.30pm-5.30pm | £4

Saturdays - Trampolining / Shokk Gym and Fun Games 10am-1pm | £5.80 | 5-15 years (bring a packed lunch with you)

Every Monday to FridayShokk Gym / Dance Mats from 4.30pm | £1.80 per session or £9.00 per month on a casual monthly payment.

First Name: Last Name:

Male Female Date of Birth: Age:

Address:

Postcode:

Home Tel: Mobile:

Email Address:

School Attended: School Year:

How did you fi nd out about these activities?

PARENT/CARER APPROVALI give permission for the above named person to take part in these activities.

In case of emergency I can be contacted on the following tel no.

If I cannot be contacted any necessary medical treatment may be be given on the advice of a suitably qualifi ed person.

Signature of Parent/Carer: Date:

Full Name: Relationship:

Which ethnic group do you consider the child/young person belongs to?

White Mixed Asian/Asian British Black/Black British Other

Does the child/young person have any long term illness, health problem or disability that limits his/her daily activities? Yes No

If yes please specify:

REF NO. OFFICE USE ONLY