Christ Church Leyton Holiday Club

Parent/Guardian first name *

Parent/Guardian emergency contact number *

Parent/Guardian surname *

Parent/Guardian email address *

Child's first name *

Child's Date of Birth *

Child's surname *

Child's School Year *

Does your child have any allergies, medical conditions, or on any medication? *

Does your child have any additional needs? *

Is there anything else we should know about your child? *

Holiday Club child ticket 0