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CGI Half Term Fun Day!

CGI Fun Day Registration

Child's Information
Child Full Name*
First Name Last Name
Date of Birth*

Day Month Year
School Year*
School *
Any allergies etc.
Is the child's mother Jewish?*

YesNo
Contact Info:
Full Name*
First Name Last Name
E-mail*
Phone Number*
Relation to Child:*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

I agree to pay*

£35

Payment*

Credit Card

We accept Visa, MasterCard, American Express
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Should be Empty:

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