February Vange Holiday Club

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** Please complete a separate form for each child attending**

An Essex ActivAte club that it is being funded by Active Essex, Essex County Council and the Department for Education

London Road Vange SS16 4QA

Holiday Club times Wed 21st Feb 9-1 Thurs 22nd Feb 9-1 Fri 23rd Feb 9-1

A glimpse at the fun you can have at our club

Childs Name
*

Childs Age *

What days will you be attending the club *

Wednesday 21st February 9am - 1pm

Thursday 22nd February 9am - 1pm

Friday 23rd February 9am - 1pm

Required

Any Medical or any other issues we need to be aware of *

Address *

Emergency Contact Number *

Email Address *

Dietary Requirements *

Vegetarian

Vegan

Kosher

Halal

Gluten-free

None

Other:

Permission for photos to be used on social media *

Yes

Would you be interested in attending other ATF activities

Yes

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What activities would your child most be interested in

How did you hear about this event?

Website

Friend

Newsletter

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Comments and/or questions

I confirm that I am eligible for a free space on the Essex ActivAte programme because:

My child is eligible for benefits based free school meals

We are a working family who is struggling financially and would benefit from this holiday club support

We are not eligible but our child will be bringing their own packed lunch

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