One Month Free

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Instructors Email

Today's Date

Day Month Year

First Name *

Last Name *

What is your relationship to the student? *

Full Name

First Name Last Name

E-mail *

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Do you have more than one child that wishes to partake in the free trial?

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Full Name

First Name Last Name

First Name *

Last Name *

Gender *

Date of Birth *

Day Month Year

Age

Relevant Medical Conditions

Does your child have any special needs that we should be aware of?

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Please provide relevant details of special needs:

Does your child receive 1:1 support in school?

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It may be wise to have a chat with us to ensure that we can provide your child with the correct level of support in our class - certain classes may be better than others with regards to adult ratios for 1 to 1 support. Feel free to give us a call on 07921855900 and ask if you might be able to speak with Instructor Nick, regarding classes that might be best for 1:1 support.

What School Does Your Child Attend: *

Has your child ever earned a colour belt during school time, in one of our curriculum classes?

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What colour would that be?

Are they attending the straight after-school (youngest) class? *

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Would you like us to pick up from the school and walk them down to the hall? *

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Please sign here to confirm that you would like us to pick up from school and walk down to the hall *

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Does this child have permission to walk home from class?

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Your Details

1st Student Details