Girls Youth Club

Registration Form

Step 1 of 3

Full name - Girl *

First

Last

Address - Girl *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone - Girl (if applicable)

Email - Girl *

Which school do you attend? *

Our girl's workshop for pupils in the S1 to S3 year group is currently full. If you would like to join the waiting list to join once a space becomes available please complete this form.

Year groups S4 - S6 have limited availability

Year Group *

Medical issues/allergies

Full name - Parent/carer *

First

Last

Address - Parent/carer *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone - Parent/carer *

Email - Parent/carer *

Full name - Emergency contact *

First

Last

Telephone - Emergency contact *

Emergency Telephone -

Relationship to girl - Emergency contact *

Please enter i.e. mother / father etc.