Entry Number (required)

    Child's Name (required)

    Child's Addresss (required)

    Child's Age (required)

    Child's School (required)

    Parent Name (required)

    Parent Telephone Number (required)

    Parent Email Address (required)

    Is your child avaliable for Carnival weekend?

    YesNo

    Parental Consent (required)

    By typing your name below, I give consent for the above named child to have his or her picture taken by Brownhills photography and used in marketing materials (Website, Printed materials and in the media) by Fleet & District Carnival Association.

    Please Enter Todays Date (required)