Sign-up Form

For a parent or guardian to complete. Questions? Contact us at tuition@villageacademy.co.uk or +44 7591 771640.

Parent / Guardian

Parent/Guardian Full Name: *

Parent/Guardian Number: *

Parent/Guardian Email: *

Address *

Please fill out the following section about your child.

Child Full Name: *

Child Date of Birth: *

Click the calendar icon to choose.

Child School Name: *

Education Status/Level: *

Select your child's education level.

Year Group: *

College: enter 12 or 13.

Child Allergies/Medical Information: *

If no allergies/medical conditions, please write 'None'.

This section is for the Parent/Guardian to fill out.

I, the parent/guardian consent to the possibility of my child being photographed or recorded for promotional or educational purposes.

AcceptDecline

I, the parent/guardian acknowledge that Village Academy Tuition Centre Ltd is not responsible for any items lost or left behind.

AcceptDecline