Rayners Lane Montessori: Secure My Place Form

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Rayners lane Montessori: Secure my Place form

About Your Child

Name of child
Date of Birth
Gender
Religion
Ethnic Origin
Nationality
Does your child have any
medical conditions or been
referred to a specialist? If Yes, please state:

Does your child have any Yes/


allergies?
1
If Yes, please state: 1

Sessions- Please tick

Session Monday Tuesday Wednesday Thursday Friday


Early Drop off (7:30am-8am)

Morning (8:00am-1:00pm)
v
Afternoon (1:00pm-6:00pm)

Full Day (8:00am-6:00pm)

Preferredstartdate: 01/A~8/~o~J . · Confirmed start date:


I

According to your sessions you have chosen your Monthly fee shall be:

(weekly fee x 52 weeks divided by 12)

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