Application Form
Day/Venue:
Monday: Berni Centre, St Martin, 9.45- 10.45 Age: 1- 4 yrs ( )
Monday: Berni Centre, St Martin 11.00 - 12.00 Age: 1-4 yrs ( )
Monday: Berni Centre, St. Martin 1.00 - 2.00 Age: 1-4 yrs ( )
Tuesday: Berni Centre, St. Martin 9.45-10.45 Age 1-4 years ( )
Tuesday: Berni Centre, St. Martin 11.00-12.00 Age 1-4 years ( )
Autumn Term dates: Term begins Monday 21th September 2009 and ends on Tuesday 1st December 2009.
There will be no Busy Fingers sessions during half term : Monday 26th and Tuesday 27th October 2009 due to half term
Cost : Each 10 week course will cost £82.00 in advance. Please make cheques payable to 'Busy Fingers'.
Please write your childs name on the back of the Cheque together with the session required.
A 10% discount can be deducted for siblings.
The Busy Fingers activity and songbook is available at a cost of £4.50.
If you would like one please add £4.50 to your total.
Parent/Carers Name ___________________________________________
Child's Name _________________________________________________
Age and date of birth ___________________________________________
Address _____________________________________________________
Home Telephone _______________________________________________
Mobile Telephone ______________________________________________
Email address __________________________________________________
I would like to buy a Busy Fingers songbook ( )
I enclose a cheque for _____________ made payable to 'Busy Fingers '
Please send payment to Helena Carnegie, 1 La Cote Verte, Rue de Samares, St.Clement, Jersey, JE2 6LP. Tel. 01534 854929 or Mobile 07797 856908.
I take full responsibility for the child/children in my care during 'Busy Fingers' sessions.
I give permission for pictures to be taken of my child whilst at 'Busy Fingers' and used in promotional material.
Signature _________________________________________ Date __________________________
N.B 'Busy Fingers' accepts no responsibility for loss, damage or theft of your property.