Lindow Community Primary School

First Name *

Last Name *

Email *

Phone *

Secondary Phone *

Alternate Contact *

We would contact this person in the event of not being able to reach you.

Alternate Contact Number *

Collection PIN / Word *

Please enter a 6 digit numerical PIN or Memorable Word. We’ll use this incase you need someone else to collect your child from us. We will not be able to release your child to anyone other than yourself if they can not quote the children’s PIN - For this reason your child PIN should be secure and not an obvious date or sequence of numbers.

I have read and understand the after school club policies, terms and conditions *

Yes

No

Password *

Confirm Password *

Parent Details