LAMDA at Leighton Park School

PARENT / GUARDIAN DETAILS Unless otherwise stated, this is the person responsible for paying the fees

Name of parent/guardian*

Telephone No*


Enrolment details. If you require any more details please email

Name of first student*

Date of birth* (dd/mm/yyyy)


Male   Female  

Name of second student

Date of birth (dd/mm/yyyy)


Male   Female  

Name of third student

Date of birth (dd/mm/yyyy)


Male   Female  

Medical conditions?

How did you hear about us?

Fields marked with * must be entered.

Once you submit your enrolment form we will be in touch with details of how to make payment.

By sending this form, I agree that photos of the above student(s) may be used for publicity purposes.

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