Blueberry Playsongs Joining Form

Personal Information:
I'd like to :
Blueberry Blueberry
Child's first name: as you would like it on name label
Child's last name:
Age: D.o.b:  
Parent's Name:    
Address:    
Postcode:    
Tel: A value is required.A value is required.Invalid format-no gaps. Mobile:
Email: A value is required.Invalid format.A value is required.Invalid format.    
Name of adult to attend class:    
       
Where you heard of
Blueberry:
   
Class information:
Centre: A value is required.
Choice of class:
Second choice of class:
   
Date joining from:
(if not from beginning of term)
Amount:
Class fee: £  
New members' fee: £  
Total: £  

Please agree to terms.Please check box . I understand that while at Blueberry, discipline and the safety of my child are my responsibility.

Method of Payment:
Please select how you would like to pay and we will reply with further instructions.
By cheque Please print form to send with your cheque  Click to print
By bank transfer We will send you payment information
Online via Paypal We will send you payment information

     
If paying by cheque please post this form with your cheque made payable to:
'Blueberry Playsongs' and post to: 17 Brookview Road, London SW16 6UA

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