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Fruity Club Parent Application Form

Location

How many children are you registering?

Parent/Carer's Name

Primary Parent/Carer's Contact Number

Parent/Carer's Email Address

Parent/Carer Address

Parent/Carer Post Code

2nd Contact Name

2nd Contact Number

2nd Contact Email Address

Please list all adults who are permitted to pick up your child:

0 / 1000 characters

Preferred Start Date

Payment Frequency

Preferred Payment Date

I agree to the Terms and Conditions

Note: Once you have completed the form and clicked submit, you will be asked to register with GoCardless. Your application will then be processed and we will be in contact shortly.