* 1. What is your child's name?

* 2. Which day do you wish to book homework club for?

* 3. What class is your child in ? 
For children in year 3 and 4 they will be escorted to this activity.

* 4. Please give the best two contact telephone numbers for you between 15.45 - 16.30 on a Tuesday or Wednesday
Ideally this will be two different people who have parental responsibility for the child.

* 5. My child has the following medical condition.

* 6. My child has allergies to the following things