WCC After School Club Application Form

Children's details

First child's name *

First Name Last Name

First child's date of birth *

Date

Second child's name

First Name Last Name

Second child's date of birth *

Date

Third child's name

First Name Last Name

Third child's date of birth *

Date

Parent/Guardian's Contact details

Name *

First Name Last Name

Relationship to child *

E-mail *

Preferred phone number *

Other phone number

I wish to book my child in for After School Club on the following days: *

Monday Tuesday Wednesday Thursday Friday

Oversubscription Criteria

In order to reflect the original aims of the club places are allocated to children according to a points systems which prioritises children whose parents who are in full time work or education. The full details of the allocation criteria can be found in the Admissions Policy on our website.

If you have any other circumstances which you would like us to consider in the case of over subscription please email us directly.

Please indicate which best describes your circumstances:

	Yes	No
single parent in work or full-time education
2 parents in full time work/education
2 parents working: 1 full time and 1 part time
2 parents 1 full time work/education
sibling currently attends after school club

Terms:

1. WCC aims to offer places in the club on an equitable basis. The information requested in this form will be used to determine the child’s place in the club/waiting list. It is essential therefore that all sections of the form are completed. Any disputes arising from the allocation of places in the club will be dealt with by the Management Committee whose decision shall be final.

2. All sessions run from 3.15 pm to 6.15 pm at £11.00 per session. Payment is per session regardless of whether a child is collected early.

3.Children must be collected promptly by 6:15pm otherwise a penalty of £5 for every 5 minutes of lateness, or part thereof, will be charged.

4. Invoices will be issued termly and all charges must be paid in advance by the dates specified on the invoice. Unpaid fees may result in the service being withdrawn.

5. A four week notice period (term time) is required if giving up a place at the club.

6. Refunds will not be offered where a session is booked and the child does not attend.

7. Upon being offered a place in the Club, parents/carers will be asked to complete the full Registration Form. Parents are obliged to keep all these details up to date and inform staff of any changes immediately.

8. Parents/guardians are required to pay an annual registration fee of £20.00 per family.

9.Parents/Guardians are required to read our policies and procedures and agree to abide by them, a summary of the policies are included in the information booklet and the full set is available on the club website or at the club.

Fee Payment

We accept payment by bank transfer, cheque or childcare vouchers. We do not accept cash.

Our bank account details are:

Account name: Walker Club, Sort Code: 40 05 21 Account No. 91394223

Parental Permission *

I agree to the terms detailed above

Date *

Date