Join Us

Fields marked with a * are required.

Name of Child *

Gender *

Date of Birth *

Address 1 *

Address 2 *

County *

Home Phone *

Mother's Name and Surname *

Mother's Mobile Phone Number *

Mother's Email Address *

Father's Name and Surname *

Father's Mobile Phone Number *

Father's Email Address *

Does your child have any special care needs? *

If you answered "yes" above, please provide a brief description

How did you hear about us? *

Your name *

Your relationship to child *

Priority will be given to children whose parents are leaders in the group. Would you like to become a leader? *