Merdon Junior School Out Of School Club Contract

Please complete our secure online form below or download, complete and return either the Word or PDF version of the contract.

Please specify if you wish for your child to attend on a regular or occasional basis:
Regular attendanceOccasional attendance

Child's name (required)

Parent/carer's first and last name (required)

Mr.Mrs.Ms.Miss.

Child's date of birth (required) (YYYY-MM-DD)

Address of child's residence (required)

Post Code (required)

Address of parent/carer's residence if different to child

Post Code

Telephone contact information:
Home:
Work:
Mobile:

Email address:

Any special requirements or passwords for pick up?

If you have/would like your child/children to attend Merdon breakfast session and wish to drop them off in the car park we need written authorisation for Jenny Knight to sign them in.

By submittting this form, I/we hereby enter into the agreement that the above child is to attend Rebecca's Out Of School Club for Merdon Junior School on the following days:

Breakfast Session (7:30am - 9:00am) £5.50 (siblings £5.25)

Afternoon Session (3.30pm - 6:00pm) £11.50

Please select wich session you would like to book on which days:

Monday:        BreakfastAfternoon
Tuseday:        BreakfastAfternoon
Wednesday:  BreakfastAfternoon
Thursday:      BreakfastAfternoon
Friday:           BreakfastAfternoon

I/We would like attendance to commence on (YYYY-MM-DD)

Four weeks notice to terminate this arrangement or fees paid in lieu. Rebecca's Out Of School Club reserve the right to withdraw its services if any fees remain unpaid for more than 1 week. We will be closed on inset days for Merdon Junior School.

Please make a £30, non-refundable, deposit to register your child's place by either:
1) making a BACS payment to TJHP Ltd T/A Rebecca's Out of School Club sort code 30-92-94 account number 02514205 or,
2) sending a cheque made payable to Rebecca's Out Of School Club to Rebecca's Out Of School Club, 34 Valley Road, Chandlers Ford, SO53 1GP

I have made payment of the non-refundable deposit

Tick to indicate your agreement to comply with Rebecca's Out Of School Club policies and procedures.
I have read and comply with Rebecca's policies and procedures.

Have you submitted your Child Information form?
I have completed a Child Information Form.

Have you submitted your Parental Permission form?
I have completed a Parental Permission Form.

Signature (Please type your name):

Date YYYY-MM-DD:

Merdon Junior School Out of School Club Contract
Merdon Junior School Out of School Club Contract
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