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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