Other Schools Out Of School Club Contract

PLEASE COMPLETE OUR SECURE ONLINE FORM

Child's name (required)

Child's class (required)

Parent/carer's fist 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:

Email address:

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 on the following days:

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

Afternoon Session (3.15pm - 6.00pm) £13.50 per session

Please select which days you would like to book:

MondaysTuesdaysWednesdaysThursdays

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 Chandlers Ford Infant 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 by either:
1) Where deposits need to be paid, you will need to contact the office on 023 8025 5686 for details. 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 a 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:

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