West of England Daily Mile School Registration Form Question Title * 1. Name of School Question Title * 2. School Address Question Title * 3. Name of PE Co-ordinator Question Title * 4. Contact Email Address Question Title * 5. Contact Phone Number Question Title * 6. How many children are there in your school? Question Title * 7. How many children do you intend to initially get involved in the Daily Mile? One year group KS1 only KS2 only Whole School Question Title * 8. Why do you want to start the Daily Mile in your School? Question Title * 9. Please provide invoice details for the £12 payment. Purchase Order number Invoice contact name Invoice contact email address Question Title * 10. I give permission for Wesport to contact me via the contact details provided Yes No Question Title * 11. Please use the box below for any additional questions or comments Finish