Caterpillar Crafts IY Booking Form

Inspiring You Country Park 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 & or mobility difficulties
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?:

QECP Sat 21st Jan
QECP Thurs 16th Feb
QECP Sat 17th March

Gateway card no:

*Payment option:

Paypal (payment request will be emailed)
Cheque (made payable to Caterpillar Crafts)

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 C.R.B checked & are covered by public liability insurance.