Name, address & telephone number of child’s doctor:
Please give details of any medical conditions staff should be aware of:
Please give details of any allergies or cultural preferences:
I agree to my child receiving medical treatment in case of a serious accident Yes/No*
I give permission for my child to be photographed Yes/No*
I give permission for my child to have face/body paints Yes/No*
I give permission for my child to have their hair braided Yes/No*
I give permission for my child to have their nails painted Yes/No*
I give permission for my child to have temporary tattoos Yes/No*
I give permission for my child to watch U and PG films Yes/No*
*Please delete as appropriate
Signed…………………………………………………………………………
Print name………………………………………………………………….
Date…………………………………………………………………………….

Extra forms can be downloaded from our website if needed.

Payment can now be made online using the details below. Please put the reference number as PS followed by your child's initials and house number (e.g. Joe Bloggs living at 15 Smith Close would use the following reference: PSJB15) and also record it here: PS…………………………………………

Sort Code: 30-90-38

Account number:02940658

Contact details

Phone: 07913758121

Email:

Address: Oak Green School, Aylesbury, HP21 8LJ

Website:

For children aged 4 – 11 years

Monday 25th July – Friday19th August 2016

@ Oak Green School

9.30am – 12pm / First child - £5.50
Additional siblings – £4.50
Lunch 12-1pm / All children - £1
1pm – 3.30pm / First child - £5.50
Additional siblings – £4.50

Booking is advisable for these sessions but not compulsory.

NEW HOURS

8.30am – 5.30pm / First child – £20
Additional siblings - £18

For a full day (8.30am – 5.30pm) children MUST be pre-booked and pre-paid. Booking and payment must be made at least a day in advance.

Holiday Club Registration Form
Childs Name:
Date of Birth:
Address & Postcode:
School Attended:
Is your child in reception/foundation stage Yes/No*
*If your child is in reception or the foundation stage there will be an extra form for you to complete.
Ethnic Origin:
Parent/Guardians Name:
Phone Numbers
Home:
Work:
Mobile:
Emergency Contact Numbers (Please provide 2 additional contacts for use in an emergency)
Please provide a password to make sure your child is collected by a person of your choice:
Does your Child attend any other out of school clubs (if yes please state)?

Please tick all sessions you wish your child to attend.

Week 1 - Film Theme / 9.30am -12pm / Lunch
12-1pm / 1pm -3.30pm / FULL DAY
8.30–5.30
Mon 25th
Tues 26th
Weds 27th
Thurs 28th
Fri 29th

Week 2 – Summer Theme

Mon 1st
Tues 2nd
Weds 3rd
Thurs 4th
Fri 5th

Week 3 – Space Theme

Mon 8th
Tues 9th
Weds 10th
Thurs 11th
Fri 12th

Week 4 – Jungle Theme

Mon 15th
Tues 16th
Weds 17th
Thurs 18th
Fri 19th

A list of more specific activities will be available on website and a printout will be available on the first day of playscheme.

All activities are subject to change, especially those that are weather permitting.

Please be aware you must provide a suitable lunch for your child. Snack will be provided throughout the day.