Enrolment Form Holiday Camp original Form
Halloween Our Holiday camp will be held in Currie Primary School throughout 2018/2019 Hazelwood is unavailable due to maintenance work.
£10 deposit required to secure your child's place.
Full day £18.50 9 am to 3 pm
Half Day £9.50 9 am to 12 pm or 12 pm to 3 pm
Early Drop off 8 am to 9 am including Breakfast £3 Late Pick up 3 PM to 4 pm including snack £3
15% Discount Full Week rate 9 am - 3 pm Monday to Friday  £78.50

Sibling discount 20% for 2 children full week  £149.00 9 am - 3 pm  Payment must be made the Friday before the child is booked in. Failure to make advance payment may result in your child not getting a place.

Email address *
Would you like us to retain the details of this form for future holiday camps? details will be held securely and in line with the Data Protection Act.
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Parent/Guardian Name: *
Your answer
Do you have parental responsibility for the child? *
Address including postcode: *
Your answer
Contact Phone number: *
Your answer
Alternative Phone Number: *
Your answer
Parent/Guardian Name: *
Your answer
Address if different:
Your answer
Contact Phone Number: *
Your answer
Alternative Phone Number:_
Your answer
Child’s Name: *
Your answer
Date of Birth: ___/___/___ *
Your answer
Age of child on entry?
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
Who is authorised to collect your child Name and Password: *
Your answer
Telephone number of person collecting your child if different from above: *
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 48 hrs notice required for change of days *
I/We hereby agree to terms and conditions of payment of fees which is payment weekly in advance of days of attend. If your child fails to attend you agree to pay the fee. *
Additional people Who is authorised to collect your child? Name & Password:
Your answer
Telephone Number:
Your answer
Date of birth:
Your answer
What dates would you like to book? Full day 9 am to 3 pm, Half Day 9 am to 12 pm or 12 pm - 3 pm Early drop off 8 am late pick up 4 pm
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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