Child’s Details
Full Name: Gender: Boy Girl D.O.B:
Address:
Postcode:
Class:
Please tick the appropriate box & give details (please tick the appropriate box and ask for a health care plan form): -
ð My child does not like the following foods/drinks
ð My child is allergic to the following foods/drinks
ð My child is allergic to medical wipes, wet ones or plasters
ð My child suffers from asthma and uses an inhaler (please state how often)
ð My child has distinguishing marks, moles or birth marks on (please specify):
My child has: - (please tick the appropriate box and ask for a health care plan form)
□ Special needs requirement □ Medication needs
Doctors Name: Contact Number:
Health care professional: Contact number:
Service requirements
Date service requested from:
Breakfastservice / Cost per day / Please select which option you would like / Please select which days you would like
7.30am-9.00am / £4.80 / Monday
8.30am-9.00am / £2.00 / Tuesday
Wednesday
Thursday
Friday
After school
club / Cost per day / Please select which option you would like / Please select which days you would like
3.00pm-4.15pm / £5.00 / Monday
3.00pm-5.45pm / £8.80 / Tuesday
Wednesday
Thursday
Friday
Full time (am/pm) / Cost per week(discounted rate) / Please tick if you require a full time place
7.30am-5.45pm / £61.20
Payment method:
ð Parent mail (online payment)
ð Childcare voucher scheme
*Late payment charges apply weekly at the cost of £5.00 per week
Parents/Carers Details
First persons holding main parental / guardian responsibility:
Title: Mr. /Mrs. /Miss /Ms First Name:
Relationship to child: Surname:
Home Address:
D.O.B:
Home Telephone No.: Day time No:
Mobile No:
Email address:
Second persons holding main parental / guardian responsibility:
Title: Mr. /Mrs. /Miss /Ms First Name:
Relationship to child: Surname:
Home Address:
D.O.B:
Home Telephone No.: Day time No:
Mobile No:
Email address:
Additional people authorised to pick up my child in the event of an emergency or illness
(must be over 16 years of age):
Name / Relation to child / Mobile Number / Home telephone numberClub requirements
Please initial at the start of each line to give consent:
………I consent to my child receiving any medical treatment which is urgently required
………I consent for the club to seek medical help or professional support
………I consent to my child having their photo taken and displayed within the club room/newspaper
………I consent to club staff assisting my child in applying sun cream
1. Admittance
Places are allocated on a first come first served basis. You will need to complete an enrolment form. If reservations exceed 48 places, parents/carers can join a waiting list and they will be allocated a place when one becomes available.
2. Fee Payment
Fees are to be paid using the online system parent mail or by using your nominated childcare voucher scheme. Payment is required in advance half termly. Non-payment of fees will result in the loss of a place. No refunds/credits are given if a child does not attend due to sickness or unauthorised absences. No discount for siblings. Parents /Carers are unable change or cancel bookings midterm.
3. Days and Hours of Opening
Children should be picked up no later than 5.45pm. St Barnabas Shining Stars reserves the right to charge £6.00 for delayed pick-ups after 5.45pm towards extra staffing costs. The club is open from 7.30am till 9.00am and 3.00pm till 5.45pm term time only. The club does not charge for Bank Holidays, Teacher Training days or emergency close days (i.e. snow). Please do let us know if you are going to be late by contacting the staff on 0751 445 2667.
4. Meals and Messy Play
St Barnabas Shining Stars cannot be held responsible for difficulties arising from any allergy which has not been notified to us in writing. May we also point out that the afternoon tea provided is in the form of a snack and not intended to replace the child’s evening meal.
5. Sickness
Any child with a rash, sore throat, discharge from the eyes, diarrhoea or any contagious/infectious illness should be kept away from the Club. If a child becomes sick during his/her attendance we will call the parents/carers in the first instance, however, we reserve the right to call for emergency assistance and if necessary remove him/her to hospital. It is not our policy to administer medicines to children unless specifically requested by the child’s parent/carer. To have medicines administered it must be prescribed by the child’s doctor and parents/carers must fill in a form obtainable from a member of the club staff.
6. Arrival and Departure of Children
Parents/carers are requested to sign their child in and out each day of attendance. No child will be allowed to leave our care with anyone other than the person named on the enrolment forms.
Please provide us with a password if someone different is collecting your child. We are happy to make other arrangements with the parent/carer for special circumstances e.g. if they are going to a friend’s house for tea.
Parents/carers must bring their child to the club and sign them in and out on each day.
7. Valuables
We cannot be held responsible for the loss of or damage to valuables.
8. Cancellations/notice
If you wish to withdraw your child from the St Barnabas Shining Stars, four weeks’ written notice is required.
9. Footwear and clothing
Parents/carers are responsible for labeling all their children’s belongings and ensuring that only suitable clothing and footwear is worn by their child to club.
10. Complaints
The club takes any complaint very seriously and undertakes to resolve the matter informally at the earliest opportunity to the satisfaction of all parties wherever possible. When necessary, St Barnabas Shining Stars will follow the schools normal formal complaints procedure.
11. Other general club information
· I understand that all the school’s policies will apply to St Barnabas Shining Stars including Child Protection and Data Protection.
· Please be aware that students may wish to monitor your child and their development as part of their studies.
· Aggressive, non-appropriate language and rude behavior by children and parents/carers towards any school/club employee will result in losing your child’s club place.
· It is understood that parents/carers must keep the club updated in writing in respect of any changes in family contact details, ongoing illness and allergies.
· Should any of our terms and conditions be changed, we will endeavour to give as much notice as possible.
12. Safeguarding
It is understood that any staff within the school/ club who considers that a child in their care may be or have been at risk will have a duty of care to report the matter to a Designated Safeguarding Person within the School, who will decide on the appropriate action required.
ð I understand that the information given on this registration form is confidential.
ð I have read and accepted the above conditions for my child attending St Barnabas Shining Stars.
Signature of Parent/Carer:
Date:
In depth information relating to the organisation of Shining Stars can be found in the Club’s handbook and on the school website.
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