Holiday Club Child Information Form

To register your child for Holiday Club, please either download, print, complete and post to us the Child Information Form as an MS Word or PDF file or, complete the secure online form below:




    Mrs.Ms.Miss.Mr.Dr.



    YesNo

    Emergency Contact Information


    Mrs.Ms.Miss.Mr.Dr.






    Mrs.Ms.Miss.Mr.Dr.





    Other information required

    Things we need to know to help us provide continuity of care

    Allergies


    YesNo



    YesNo

    Food/Drinks (especially fruit and snacks)


    Activities


    Language


    YesNo


    Religion


    Festivals


    Health


    Asthma/breathing problems YesNo
    Skin conditions YesNo
    Hearing difficulties YesNo
    Sight difficulties YesNo
    Speech difficulties YesNo
    Any long term illness/conditions YesNo









    Arrival/Departure

    List the names of anyone (other than parents) who will be delivering/collecting your child.


    Mrs.Ms.Miss.Mr.Dr.









    Mrs.Ms.Miss.Mr.Dr.









    YesNo.
    If yes, please give details

    Any other information


    Signature



    Rebecca's Child Info Form
    Rebecca's Child Info Form PDF
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