Please note, we are currently only offering Regular Attendance.

Child's name (required)

Parent/carer's first and last names (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:

Mum’s email address:

Dad’s email address:

Full Fees will be charged for absence

If exisiting parents are just updating the contract a deposit does not need to be paid

Any special requirements or passwords for pick up

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 Scantabout Primary School.

Breakfast Session (7:30am - 9:00am) £7.25 (siblings £7.00)
Afternoon Session Early (3:20pm - 5:00pm) £13.75 (siblings £13.25)
Afternoon Session Late (3:20pm - 6:00pm) £15.75 (siblings £15.25)

Please select which session you would like your child to attend days:

Monday:        BreakfastEarly AfternoonLate Afternoon
Tuseday:        BreakfastEarly AfternoonLate Afternoon
Wednesday:  BreakfastEarly AfternoonLate Afternoon
Thursday:      BreakfastEarly AfternoonLate Afternoon
Friday:           BreakfastEarly AfternoonLate Afternoon

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. You will not be charged for inset days.

I enclose a £30.00 non refundable deposit (please tick if deposit is included). If existing parent and just updating the contract a deposit does not need to be paid.

Please make cheques payable to: TJHP Ltd or Rebecca’s Out Of School Club. Bacs payment account number 02514205, sort code 30-92-94.

NB: Any collection after 5pm will result in an additional £2.00 charge being made. If, however, they are picked up after 6pm another additional fee of £15 per every 15 minutes will be charged.

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: