Home
What we offer
Where to find us
Meet the team
Home
Baby Massage
Baby Yoga
Activity Classes
Timetable
Gallery
Home
What we offer
Where to find us
Meet the team
Home
Baby Massage
Baby Yoga
Activity Classes
Timetable
Gallery
Activity Class Registration Form
Your Name
*
Your Name
First Name
Last Name
Contact Number
*
Email Address
*
Child's Name
*
Child's Name
First Name
Last Name
Child's Date of Birth
*
Child's Date of Birth
MM
DD
YYYY
Relation to child
*
Post Code
*
Mother / Father's Name
Mother / Father's Name
Or other person to use as Next Of Kin
First Name
Last Name
Does the child have any allergies?
Does the child have any learning difficulties?
Does the child have any physical or mobility difficulties?
How did you hear about Sensory Land?
*
e.g. Hoop, Flyer, Facebook group
How do you rate this class out of 5?
*
1 is the worst - 5 is the best
Please select
5
4
3
2
1
Do you have any feedback?
Thank you!