The Den Wraparound Care Registration Form

SESSIONS AVAILABLE

Breakfast Club sessions are - 7.45 - 8 am arrival (£4.00 / £3.50 (sibling))

8 - 8.30 am arrival (£3.50 / £3.00 (sibling))

After School Club - 3.15 - 4.15 pm - £4.50 per child 3.15 - 6pm - £12.00

£1.50 per 15 mins charged for each additional 15 mins after 4.15 pm

A 10% sibling discount is applied to After School Club charges.

Please complete all sections of the registration form as indicated.

THE BOOKING FORM SECTION ONLY REQUIRES COMPLETING FOR AFTER SCHOOL CLUB SESSIONS NOT BREAKFAST CLUB.

Please consider your booking carefully. Bookings may be changed within 24 hours prior to your booked session by letter/email or message to the school office or Miss Kane direct on 07590642771. If less than 24 hours given a charge will be made for the session slot booked.

REGISTRATION FORM

Please complete 1 registration form per child

First Name Last Name

Is this child a sibling?

Parent Name

First Name Last Name

Email

example@example.com

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number

Medical Information

Please provide us with any relevant medical information such as dietary, allergies, medical conditions we should be aware of. PLEASE NOTE: THE SCHOOLS NORMAL PROCEDURES FOR THE ADMINISTRATION OF MEDICINE OR FIRST AID APPLIES AT BEFORE & AFTER SCHOOL CLUB.

Emergency Contacts

WE REQUIRE AT LEAST 2 ALTERNATIVE CONTACT NUMBERS

Consent

I confirm all consents given in school regarding medical treatement, internet use and photographs applies to Before & After School Club. I confirm I have read that all the school's safeguarding, behaviour, equal opportunities and health & safety policies apply at Before & After School Club.

BOOKING FORM - Sessions Required


Monday
Tuesday
Wednesday
Thursday
Friday

I require a place at BREAKFAST CLUB only - Breakfast club operates on a drop in basis no need to book.

YES NO

I require a place at After School Club on a regular basis

YES NO

I confirm I must book my child's sessions at After School Club by contacting Miss Kane on 07590642771 or the office on 01827 429011.

YES NO

I confirm I am aware of the 24 hours minimum notice for cancellation policy and I am aware that if my child's place is cancelled with less than 24 hours notice charges will still apply

YES NO

I am aware Breakfast Club charges are debited daily and After School the Monday after my child attends.

YES NO

I am aware my Parent Pay accounts must be kept in credit at all times and if debts are not cleared my places at club will be withdrawn.

YES NO

My preferred method of payment is:-

Parent Pay Childcare voucher

My childcare voucher provider is:-

Booking Conditions 1). No refunds are available unless the places or sessions are cancelled at least 24 hours. 2). All school policies and procedures are in place during holiday club including those regarding behaviour. 3). A £15 per 15 minutes late collection fee will apply if your child is collected after the end of the session time booked. 4). FOOD IS NOT PROVIDED AT CLUB SO PLEASE ENSURE YOUR CHILD HAS THE RELEVANT SNACKS WITH THEM IN A NAMED BAG OR LUNCH BOX WHEN THEY ATTEND 5). If my account is in debt balance I understand my place will be removed until the account is in credit. I confirm I have read the above conditions.

Please read and confirm you have understood the booking conditions for holiday club.

'The Den' Before & After School Club Registration Form