Please note, we are currently only offering Regular Attendance.

Child's name (required)

Child's class (required)

Parent/carer's first name 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:

Full Fees will be charged for absence

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

Any special requirements or passwords for pick up?

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

Afternoon Session (3:20pm - 6:00pm) £13.50

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

MondayTuesdayWednesdayThursday

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 may be closed on inset days for either school, you will be given four weeks notice of this and not charged.

Please make a £30, non-refundable, deposit to register your child's place

Where deposits need to be paid, you will need to contact the office on 023 8025 5686 for details.

I have made payment of the £30 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: