Clubs Registration Form

Address *

Child's class for 2019/20 *
Medical details (incl any food allergies and preferences)
Parent's Name (also emergency contact) *

First Name Last Name
Mobile phone number *
Email address *
2nd contact person (parent/carer) and contact phone number
Breakfast Club sessions required (7.30-9.00) £5/session

Monday Tuesday Wednesday Thursday Friday
After School Club sessions required (15.00-18.00) £15/session

Monday Tuesday Wednesday Thursday
Names and relations of people authorised to collect my child (eg. Anna Johnson - grandma)
One name per line please
Password for collection
Breakfast Club - St. Andrew's School - Daily Mile 8.30am

My child can take part I do not wish my child to take part
Privacy policy and confirmation *

I confirm that I wish to book the above sessions and that I will be invoiced for these. Any reduction in sessions require half-terms notice. I understand that I will only be contacted in relation to this booking form and that MHPS will not share my details with anyone else. You can ask for our full Privacy Policy at any time. Full set of our other policies are also available
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