DigitallyCoolCoders & Holmleigh Primary         Activity Food Playscheme                                 Booking Form
Please fill out this form if you wish for your child to attend the holiday playscheme:
Full Paying Days;
Free of charge; Or
On Concession.

Please note this is not Holmleigh Holiday Club. 

TEMPORARY LOCATION will be at :

Stoke Newington Secondary School - Clissold Road, Hackney, London, N16 9EX

AGES: 5 - 11 years primary school ages

TIME: 9:00 am - 4:00 pm (early drop off from 8:00 am and late pick ups till 5:00 pm)

WHEN: Summer Holidays please see dates on form. 

Normal Days Cost   -(not entitled to free school meals) : 
Full Paid Days cost: £25.00

HAF Concession Days Cost - (Your child is Registered  for free school meals) : 
Half days - Free 
Full days £6.00

If you don't know if your child is entitled to a free school meals, you can CHECK HERE by visiting this link fill in the details and you will get a verified certificate to prove your child is entitled : https://pps.lgfl.org.uk/    

Once we have received your booking we will be in touch for you to make your payment if required. Thank you.
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Email *
Parent First Name  *
Parent Last Name  *
Parent Contact Telephone Number *
Parent Contact Email *
1st Child  - First and Last Name  *
1 st Child age  *
1 st Child date of birth *
2nd Child - First and Last Name 
2nd Child age
2nd Child date of birth
3rd Child - First and Last Name 
3 rd Child age 
3rd Child date of birth
4th Child - First and Last Name 
4th Child age 
4th Child date of birth
Please tick which days your child will be attending for the Free/Concessions  
Child 1
Child 2
Child 3
Child 4
30th July
31st July
1st Aug
2nd Aug
6th Aug
7th Aug
8th Aug
9th Aug
13th Aug
14th Aug
15th Aug
16th Aug
27th Aug
28th Aug
29th Aug
30th Aug
Please tick the PAID days your child will attend.
Child 1
Child 2
Child 3
Child 4
29th July
5th Aug
12th Aug
Do you require a half a day or a full day, please select? *
Required
Do you require early drop off's or late pick ups? (extra charge of 3.00 pounds)
Please let us know the name of the school your child/red attend if it is not Holmleigh Primary School?
Please let us know if your child requires any SEND needs?
Please let us know if your child have any food allergies?
Do you give permission for taking photos at playscheme of your child/ren? Please tick all that apply.
Next of kin & Emergency contact number  
Best means of contact? *
Any other information you wish to tell us?
Please tick the box to say that you understand that the playscheme will be held at Stoke Newington School Clissold Road and not at Holmleigh Primary school as Holmleigh is currently undergoing renovations? *
Required
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