|
KOOL
KIDS CLUB Registration
Form
Child's
full name |
|
Name
to be known as |
|
Date
of birth |
|
Age
|
|
Address:
|
Religious
Beliefs: |
|
Home
Tel no. |
|
Mobile
Tel no. |
|
Start
Date |
|
Contact
1 |
Name
|
|
Address
or employers address |
|
|
|
Relationship
with child |
|
Contact
Tel no. |
|
Contact
2 |
Name
|
|
Address
or employers address |
|
|
|
Relationship
with child |
|
Contact
Tel no. |
|
Name
and address of doctor |
|
|
|
Tel
no. of doctor |
|
| Password
to be used |
|
Name
and Tel no. of person(s) to contact in case of an
emergency |
|
| Does
your child have any special needs? (illnesses, allergies
or disabilities) |
Do
you give permission for your child to use the club
sun cream during summer months?
YES
NO |
Do
you give permission for your child to receive appropriate
medical attention in the case of an accident or emergency?
(You will be contacted immediately in such circumstances.
If we fail to contact you, a doctor may deem it necessary
to proceed with treatment before parental consent
can be obtained)
YES
NO
|
Do
you give permission for your child to wear a plaster
if the occasion arises?
YES
NO |
Do
you give permission for your child to be taken on
outings under the close supervision of a Playworker?
(This may include public transport occasionally)
YES
NO |
Do
you give permission for your child to have their face
painted?
YES
NO |
Do
you give permission for your child to be photographed
at the club for publicity purposes? YES NO |
Do
you give permission for your child to be videoed at
the club for publicity purposes?
YES
NO |
Do
you give permission for your child to be photographed
at the club for our records?
YES
NO |
Do
you give permission for your child to be photographed
and observed for E.Y.F.S. purposes? YES NO |
Do
you give permission for your child's first name/artwork/full
name to be published in School's Out/ School Newsletter/School
Website/York Childcare Website?
Delete
as Applicable. YES NO |
Do
you give permission for your child to use art materials
that have an over 8 age specification? E.g. Fimo YES
NO |
Do
you give permission for your child to apply make-up/
non-permanent hair products?
YES
NO |
Do
you give permission for your child to watch U and/or
PG rated films.
YES
NO |
I
declare the above information to be true and promise
to contact the Setting Manager if any of the details
change. |
Signature
|
Parent/guardian
|
Date
|
Full
name |
PARENTS PACK
CLUB/PARENT
COPY 
After
School Club Booking Form
This
form details the booking needs for your child/ren at the
After School Club and amount of fees due. If you have any
queries about your booking please phone the Manager on 07503020035.
Please
complete the details of how you wish to pay, sign below
and return both copies of the whole form together with your
first payment at least a week before your child's first
session.
Child:
Parent:
Address:
I/We
require the following After School Sessions (please tick):
The
Charge for the
term is as follows: (weeks less
inset days)
|
Weekly
|
Half
Term |
Full
Term |
Sessions
|
|
|
|
Cost
|
|
|
|
1
session costs £6.50 per child.
All
payments are to be made in advance.
Please
indicate which payment method you wish to use (delete as
appropriate):
Weekly
1 payment of
before the first session attended and further
Weekly
payments of by each Fri thereafter commencing
Fri
Half
Term 1 payment
of due at before session attended; 1 payment
of
Due
By
Full
Term 1 payment
of due before first session attended.
Cheques
should be made payable to KOOL KIDS CLUB. Refunds for
cancellations notified in accordance with club rules will
be credited to your next booking. Failure to pay fees in
advance for sessions may lead to your allocated place being
withdrawn.
I
agree to pay club fees by due dates shown.
Signature:
Name: Date:
Breakfast
Club Booking Form Club/Parent
Copy
Please
complete the details of your child's/ren's Breakfast Club
session requirements and the total fees due per week or
month. If you have any queries about your booking please
phone the Manager on 07503020035.
Please
also complete the details of how you wish to pay, sign below
and return one copy of the whole form.
Child:
_________________________________________________
Parent:
_________________________________________________
Address:
__________________________________________________
I/We
require the following days at Kool Kids Breakfast Club starting
from the week beginning:
.
|
Weekly
|
Monthly
|
Number
of Sessions |
|
|
Cost
of sessions
|
|
|
1
session costs £2.50 per child. 5 sessions cost £12.50
per child.
All
payments are to be made in advance. Both options require
payment one week in advance of the first session attended.
Please
indicate which payment method you wish to use (delete as
appropriate):
I
wish to pay Weekly/Monthly and agree to pay the full week/month
one week in advance of the first session attended.
Signature
of Parent/Carer
.
Print
Name
Date
..
Cheques
should be made payable to KOOL KIDS CLUB. Failure to pay
fees in advance for sessions may lead to your allocated
place being withdrawn.
Manager's
Signature
.
Places
allocated on
Date
Kool
Kids Club
c/o
Clifton With Rawcliffe School
Junior
Site
Rawcliffe
Lane
York
07503020035
Registration
Number: EY297010
Charity
no 1111227
Walking
Rules
•
Stay on the pavement, away
from the road.
•
Stay in line.
•
Be kind and polite to fellow
walkers, not pulling, pushing or kicking.
•
Walk sensibly and hold hands
•
Listen to the adult walkers.
•
Walk carefully on wet, slippery
or icy ground.
When
crossing the road you must
•
Stop.
•
Look both ways.
•
Listen.
•
Wait for the adult walkers
to tell you when it is safe to cross.
•
Cross sensibly and quickly,
but do not run.
I
have read , understood and agree to follow these rules.
Signed
..
Kool
Kids Club
Rules
for Responsible Internet Use
These
simple rules will keep everyone safe and be fair to others.
•
I will only
use the system with my user login
•
I will not
access other people's files
•
I will not
bring floppy discs from outside of school unless I have
been given permission
•
I will always
ask permission from a member of staff before using the
internet
•
I will only
email people I know, or the club staff have approved
•
The messages
I send will be polite and responsible
•
I will not
give my home address, phone number or arrange to meet
someone unless my parents, carer, teacher or Kool Kids
Staff member have given permission
•
I will report
any unpleasant materials or messages sent go me. I understand
my report would be confidential and would help protect
myself and others
•
I understand
that the school may check my computer files and may monitor
the internet sites I visit
I
have read and agree to the rules above
Signed
____________________________________________
Disclaimer
concerning children's personal property brought to
Kool
Kids Club.
Our
insurance does not cover your child/childrens own personal
items:
Jewellery,
watches, MP3 players, Ipods, mobile phones,
Bikes,
Scooters, Nintendo games etc.
Kool
Kids Club is not liable for any damage, loss, theft, or
vandalism to your child's own property while it is at Kool
Kids Club.
Wheelie
Days
We
are happy for your child to bring their bike, scooter, skates
or skate board to Kool Kids Club on the designated wheelie
days during the after school club and any day except wednesdays
at the holiday club.
They
must also bring and wear any safety equipment that they
normally wear when playing on their wheels at home.
They
will be effectively supervised during this activity but
we do not accept any liablilty for any accidents that may
arise from your child's use of their equipment, if they
are not wearing suitable safety gear.
The
children are expected to follow the club rules especially
while using this type of equipment and any non compliance
means that your child will not be allowed to continue playing
on their or the clubs' wheeled toys.
Please
sign below that you agree to the above terms and conditions
for the use of wheeled equipment by your child/children
at Kool Kids Club.
I
accept the terms and conditions of the use of
wheeled
toys
at Kool Kids Club.
Child's
name
|
