Rebecca’s Holiday Club

October 2019

October 2019

To register a place on Rebecca’s Holiday Club October 2019, complete the secure online form below or, download, print, complete and return to the PDF or MS Word document.

We also need an accompanying Holiday Club Child Information Form and Parental Permission Form. Please complete EVERY section on all 3 forms.

To enable us to prioritise your registration a non-refundable deposit of £15 is required, this can be paid by BACs transfer, over the phone by credit/debit card. Further instructions will be provided upon submission to your registration.

Please complete EVERY section

Child's name (required)

1st Parent/carer's name (required)


2nd Parent/carer's name (required)


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:

Email address:

Any special requirements or information we should know?

By submittting this form, I/we hereby enter into the agreement that the above child is to attend Rebecca's Holiday Club during the Summer holiday 2019, 29th July - 16th Aug 2019

All day session (7:30am - 6:00pm) £34.75
Morning Sessions (7:30am - 12:30pm) £23.25
Afternoon sessions (12:45pm - 6:00pm) £23.75

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

Monday 28th October 19: All dayMorningAfternoon

Tuesday 29th October 19: All dayMorningAfternoon

Wednesday 30th October 19: All dayMorningAfternoon

Thursday 31st October 19: All dayMorningAfternoon

Friday 1st November 19: All dayMorningAfternoon

Please make a £15, 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.

Fees are required, in full, on or before the first day of attendance.

Rebecca's reserve the right to withdraw its services if any fees remain unpaid for
more than 1 day.

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.

Have you submitted your Bouncy Castle disclaimer form?
I have completed a Bouncy Castle Disclaimer Form.

Have you submitted your Privacy Notice form?
I have completed a Privacy Notice Form.

Signature (Please type your name):


Download contract
Rebecca's October Contract
Rebecca's October Contract
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