Registration form
First name
*
. This is a required field
Last name
*
. This is a required field
Email address
*
. This is a required field
Phone number
*
. This is a required field
We might need to send last minute info about a class
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Password
*
. This is a required field
Show password
Repeat password
*
. This is a required field
Emergancy contact number
*
. This is a required field
Emergency Contact Name
*
. This is a required field
Date of Birth (DD/MM/YYYY) Min Age 8
*
. This is a required field
Does the participant have any medical conditions that will affect the activity? (Y / N)
*
. This is a required field
Yes
no
Information on medical conditions that will affect the activity?
*
. This is a required field
I agree that photos may be taken of me/the participant and can be used for future promotional material, including social media with the London Borough of Bexley.
*
. This is a required field
Yes
No
Anti-spam
*
. This is a required field
Please type the word:
community341
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