‘NORTHDOWNS’Kidz-
AFTER SCHOOL AND HOLIDAY PLAY SCHEME
LOCATED WITHIN CULVERSTONE GREEN SCHOOL
Michala Loe Tel: 07758 007842
/
SUMMER BREAK
2014
BOOKING FORM
/ HOLIDAY CLUB BOOKING OPTIONS
SHORT DAY:8am-3pm 11am-6pm
£18.50
LONG DAY: 8am-6pm
£22.50
STOP AND PLAY:11am-3pm
£12.00
DISCOUNTED LONG DAY SESSIONS
4-PER WEEK: £84.00 Per 1st Child
£82.00 Per sibling
3-PER WEEK: £66.00 Per 1st ChiId
£64.00 Per sibling
Book by 30th june 2014 to receive your discount
All Children will need a packed lunch. Both Long & Short Day bookings include healthy snacks: Breakfast &/or Tea. Water, fresh fruit juice & milk are provided with snacks.
Please note breakfast is served until 9am and tea is served at 4pm
Return forms via the school office,email or post to
North downs Kidz c/o Culverstone green primary school, Wrotham road, Culverstone, Gravesend, Kent, DA13 0RF

CHILDS NAME / PARENT NAME
DOB / CONTACT NUMBER
SCHOOL / EMAILADDRESS
Please make your booking selections below. / 8-6PM / 8-3PM / 11-3PM / 11-6PM
THURS 24th July / PETER PAN- Pirate day
FRI 25th July / CARS- Design a new car/ time challenge
MON28th July / TOY STORY- Find woody and save the toys
TUES29th July / TURBO- trail blazing snail racing and other activities
WED30th July / WINNIE THE POO- Den building/ pick up sticks
THURS31st July / FROZEN-Do you wanna build a snowman art?
MON 4th Aug / LION KING- tribal head dresses and dancing
TUES 5th Aug / MONSTERS UNI- A day of team games and events
WED 6th Aug / CINDERELLA- Ball gown fashion show/ pumpkin race
THURS 7th Aug / TREASURE PLANET- Treasure trails
MON 11th Aug / BRAVE- The Scottish highland games/sew a tapestry
TUES 12th Aug / BUGSLIFE- Circus skills and The ugly bug ball
WED 13th Aug / THE LITTLE MERMAID- water play day
THURS 14th Aug / HOW TO TRAIN YOUR DRAGON- team games day
Please note that a 25% deposit is due now with your booking
FULL AMOUNT DUE FOR YOUR BOOKING / £
All deposits made are non refundable, full payment for booked sessions will be invoiced when your booking is confirmed. If you need to cancel due to unforeseen circumstance any refunds or amendments to fees due are made at the manager’s discretion. Refunds cannot be made for general absence or illness. Signing/typing your name and returning this form states you agree to these terms and conditions.
Parent/guardian signature :………………………………………………………………Date …………………….
(Email booking: please type name to show agreement to terms & conditions.)
Cheques made payable to “North Downs Kidz”
BACS PAYMENT TO: 51- 81- 07 83029958 PLEASE USE YOU SURNAME AND SUMMER AS YOUR REFERENCE
ONE OFF BOOKINGS ONLY- ONE FORM PER CHILD PLEASE this form can be copied. Note: If you wish to use our services again full registration is required
CHILD’S NAME: / PARENT/ GUARDIAN’S NAME:
D/O/B M / F / CONTACT NUMBER:
(1ST CONTACT)
HOME ADDRESS:
TELEPHONE NO:
EMAIL ADDRESS:
PREFERED CONTACT METHOD EMAIL POST / ADDRESS IF DIFFERENT FROM CHILD’S:
DIETARY REQUIREMENTS / ADDITIONAL EMERGENCY CONTACTS:
(MINIMUM OF ONE PLEASE)
MEDICAL CONDITIONS, ALLERGIES OR SPECIAL NEEDS? / DOCTORS NAME:
ADDRESS:
TELEPHONE NO:
PRESCRIBED MEDICINES / COLLECTION PASSWORD:

EMERGENCY MEDICAL TREATMENT

I agree to a qualified first aider giving first aid treatment to my child in the event of a minor injury. I agree to the person in charge of caring for my child/ children seeking emergency medical advice and/or giving consent on my behalf for emergency medical treatment including injections or anaesthesia should the need arise.
Please indicate if your child can use plasters: Y N
Parent/Guardian’s Signature:………………………Date………… / SUN PROTECTION CREAM
It is our policy to apply sun cream if the weather is hot. Please provide sun cream with your child’s name on. Please note we will use Boots Soltan in an emergency.
Sign below to give consent for staff to apply sun cream and to use our sun cream in an emergency.
Parent/Guardian’s Signature:……………………………….. Date:……………………..
PHOTO CONSENT
  • I do not agree/I do agree to my child being included in photos taken and for them to be on display within the club premises.
  • I do not agree to/I do agree to photos of my child being included in club news letters.
  • I do not agree/I do agree to photos of my child being included in leaflets and advertisements for the club.
  • I do not agree/I do agree to photos of my child being included on your web page.
(Please delete as appropriate)
Parent/Guardian’s Signature:……………………………….. Date:……………………..