Registration Form

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Registration Form

Email *

Child's Full Name *

Child's School *

Loxdale Primary School

St Martins Primary School

Wilkinson Primary School

Required

Child's DOB *

Name of parent/Carer *

Home Address *

Mobile Number *

Work Address *

Emergency Contact details *

Details of Person authorised to collect (if applicable):

Doctors Surgery details *

Dietary requirements

Medical conditions/Allergies/SEND *

Photograph permission *

In the event of a toilet accident I give consent for staff to provide support with my child cleaning/changing in line with intimate care policy available on request. *

Yes

FOR WILKINSON/St.MARTINS COLLECTIONS ONLY

Please indicate which of the following your child will need to travel:

Full Car Seat

Booster Seat

No Full/Booster seat required

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Moore's Childcare Services Limited registered company number 11864670 trading as MCS LTD. Terms and conditions * Pay session price agreed via payment link from MCS LTD.Unpaid sessions will result in late fee and a frozen account YOUR CHILD WILL BE UNABLETO ATTEND UNTIL ARREARS ARE CLEARED (Interest will be applied daily). MCS LTD will seek legal advice regarding unpaid fee’s and they may take legal action please see uncollected fee’s policy* Notifying MCS LTD 24 hours in advance to cancel a session for a full refund.(Less than 24hours notice then 50% refund)* MCS LTD may give my child medical treatment in the event of an emergency including the use the Loxdale Primary School emergency inhaler if required.* MCS LTD may share my information with other agencies if required.* MCS LTD will not accept responsibility for my child’s possessions/valuables whilst he/she is attending the club.* It is my responsibility to keep the Staff updated of any changes to the information supplied above including who collects my child. * Staff reserve the right to refuse collection from an unnamed person and may call you to confirm if another person is allowed to collect your child. *MCS LTD adopt the "It's Everyone's responsibility to safeguard children" approach in line with Keeping children safe in education. MCS LTD will respond to any safeguarding concerns in line with their safeguarding policy, more details are available on the website. *

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