Enrolment Form After-schools Women's Tec 2018
After school Part Time daily rate 2 pm £17.50 3 pm £14.50
After school Full Time daily rate 2 pm £ 16.50 3 pm £13.50
Sibling discount 2nd child 2 pm £14.50 3 pm £12.50
Sibling discount 3 rd child 2 pm £14.00 3 pm £12.00
Early closure when school closes at 12 pm £5.00
Holidays Full Time daily rate £33
Holidays Part Time half day daily rate 8 am to 1 pm or 1 pm to 6 pm £18
Holidays Week Full week with discount £150.00
Email address *
Details will be held securely and in line with the Data Protection Act. Marketing Permissions Wee Chicks will use the information you provide on this form to be in touch with you and to provide updates and marketing. Please let us know all the ways you would like to hear from us. You can change your mind at any time by contacting us at info@weechicks.com. We will treat your information with respect. For more information about our privacy practices please visit our website. By clicking below, you agree that we may process your information in accordance with these terms. *
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Child’s Name: *
Your answer
Date of Birth: ___/___/___ *
Your answer
Age of child on entry?
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Parent/Guardian Name: *
Your answer
Contact Phone number: *
Your answer
Alternative Phone Number: *
Your answer
Do you have parental responsibility for this child? *
We need two contacts to be held on file. Parent/Guardian Name: *
Your answer
Contact Phone Number: *
Your answer
Alternative Phone Number:_
Your answer
Who is authorised to collect your child. Only people named can collect your child. Name and Password: *
Your answer
Telephone number of person collecting your child if different from above: *
Your answer
Name child prefers to be called:
Your answer
Child’s Address If different: _
Your answer
Does your child understand English? *
Is your Child on any medication? *
(if yes please give details)
Your answer
Is your child up to date with immunisations? *
Does your child have any allergies? *
If yes please specify:
Your answer
Doctors Information Name:
Your answer
Address:
Your answer
Telephone number:
Your answer
Does your child have any impairments?
Please give details:
Your answer
Additional Comments & Information: Is there is any other information that that would be helpful to our management and staff?
Your answer
Parental/Guardian Consent (tick as appropriate) I/We give my/our permission to act on my/our behalf in case of emergency or accident and to take such action as may be necessary for the benefit of the child. The decision to be taken by the person in charge at the time of the emergency *
I/We agree to pay all reasonable costs/expenses which might be incurred in this event. *
I/We give my/our permission for my/our child to be photographed by staff for the purposes of displaying in the units, for press releases, our website and social media. All photographs will be destroyed when the display is taken down. I/We hereby give my/our permission for my/our child to be included in press releases issued by Wee Chicks Fitness CIC / Wee Chicks LTD *
I/We hereby give permission for my child to be given Calpol/Nurofen (delete if appropriate) when
necessary by the unit manager or assistant. *
I/We hereby given permission for hypo allergenic plasters to be used on my/our child if necessary? *

I/We hereby give my permission for staff to assist with cleaning my child in the event of a toileting
accident. *
I/ We hereby give permission for staff to apply sun cream to my child if necessary *
Required
I/We agree to give notice to Wee Chicks Fitness CIC / Wee Chicks LTD when changing days of attendance. If your child does not turn up for a session they are book in for, the session cannot be transferred. At least 1 months notice required for change of days *
I/We give Wee Chicks permission to take my child to the Waterworks, Cavehill, Belfast Castle and Chichester Library and local walks.
I/We give Wee Chicks permission to collect my child from school and be transported in our car
I/We hereby agree to terms and conditions of payment of fees. If your child fails to attend you agree to pay the fee. *
What days would you like your child to attend? *
Your answer
What school does your child attend and what time do they need collected at? *
Your answer
Parent/Guardian signature: By typing your name it is accepted as an electronic signature. *
Your answer
A copy of your responses will be emailed to the address you provided.
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