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Outdoor Adventures Booking Form
NOTE: This information will be held purely for monitoring & information purposes & to help us ensure that we are meeting the needs of your child & all children.

*indicates required fields 
  *Name of child/ren:
  *Home address:
  *Date of birth:
  Age range:  0-4
 5-16
 17-19
  Gender:  Male
 Female
  Do they have any type of disability?:  Yes
 No
  If yes, what is the nature of your child's disability?:  Autism spectrum disorder
 Significant complex health
 Sensory
 Mobility
 Other
  *School/College or Early years provider that the child attends:
  *Parent or Carer name/s:
  *Contact phone number:
  *Contact email:
  *Which date would you like to book?:  C@tch 27th July 2017
 C@tch 3rd August 2017
 C@tch 15th August 2017
 C@tch 22nd August 2017
  Gateway card no:
  *Payment option:  PayPal (click on PayPal icon on booking info pg)
 Cheque (made payable to Caterpillar Crafts)
  Do you require Care Support?:

Please note cheque payments should be posted at time of booking to Caterpillar Crafts, 57b London Rd, Cowplain PO8 8UJ After filling the details click on the SUBMIT button.

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Caterpillar Crafts staff are DBS checked & are covered by public liability insurance.

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