Holiday Club Registration

Each daily session costs £20 per child
A half-day costs £12.50

Registration includes a £50 deposit.
This will be a secure transaction via Paypal if online.
Otherwise please send via cash or BACS (not cheque)
Please contact us for our bank details if required

There is a charge of £10 for every 10 minutes you are late when collecting your child after 6pm.

 Please let us know of any changes of circumstances
(Phone numbers, addresses, emergency contact details etc.)
 If your child is not attending Kiddyclub for any reason please contact us immediately.

To sign up your child please fill in the online form below

(or if you prefer – print, sign and post the following documents)

KiddyClub Holiday Registration Form 2015
Parent Carer’s Contract


Kiddyclub Online Registration Form

Sender's Details

Your Name

Your Email

Child's Details

First Name

Surname

What s/he likes to be called

Date Of Birth:

eg if your child was born 12th March 2010 - type 12/03/2010

School attended:

First language:

Name of key person:

Is your a child an EFYS child?

Parent/Guardian Details

Title:

First Name:

Surname:

Home Address:

Does this child normally live at this address?

Work Address:

Home Number:

Mobile Number:

Work Number:

E-Mail Address:

Does this person have parental responsibility?

Second Parent/Guardian Details (if applicable)

Title:

First Name:

Surname:

Home Address (if different):

Does this child normally live at this address?

Work Address:

Home Number:

Mobile Number:

Work Number:

E-Mail Address:

Does this person have parental responsibility?

Does anyone else have parental responsibility for this child? If so, please provide details below.

(please provide details of two people we can contact if we are unable to get hold of you)

First Emergency Contact Details

Name:

Telephone Number:

Mobile Number:

Address:

Relationship to the child:

Second Emergency Contact Details

Name:

Telephone Number:

Mobile Number:

Address:

Relationship to the child:

Child's Doctor

Telephone:

Address:

About Your Child:

Please detail any additional/special needs your child has: (please provide full details)

Please detail any dietary requirements / food allergies for your child: (please provide full details)

Is there anything your child doesn’t like (food, games etc) or is scared of?

What are your child’s favourite activities?

I,

being the Parent/Legal Guardian of

declare that the information given in this application is correct and hereby apply for a place for my child at Kiddyclub. I understand that Kiddyclub reserves the right to restrict admission at its own discretion.

By sending this form you agree that the information you have submitted is true to the best of your knowledge.
I have read and understand the terms and conditions and agree to be bound by them.