Contact Us

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2 Powerscroft Rd
London, E5
United Kingdom

(+44) 774 997 3791

French language saturday school for adults and children in London Hackney - école FLAM de Français pour adultes et enfants à Londres Hackney. Bibliothèque / Library: plus de 1 500 livres et magazines en Français.  

6 - registration 2016 - 2017

REGISTER THIRD CHILD

 

 

ABOUT YOU
YOUR THIRD CHILD
Child name *
Child name
Please indicate all nationalities of the child if more than one
As of Sept 2016
As of Sept 2016
CHILD HEALTH INFORMATION
Doctor - Surgery phone number *
Doctor - Surgery phone number
Do not include the 0 at the start of the phone number
Please state here any medications your child is taking on a regular basis.
Please state here any physical conditions such as allergies, diabetes, etc that Les Crocodiles should be aware of.
Vaccinations up to date?
Emergency Medical Care Consent *
If I, my child’s emergency contacts listed above, or the physician listed above, cannot be reached in an emergency, I authorise Les Crocodiles employees or legal representatives to obtain emergency medical care for my child while under Les Crocodiles care, including transporting or sending my child to an available hospital or physician.