Club 'Xpress, Holiday Club, May 29th-31st 2019 for children aged 5-11yrs old.
If you would like to register your child for the May Half term club please fill in the form and pay by bacs, cheque or cash. Charges:
£10 for children on free school meals living locally in post codes W2, W9,W10, W11,
£20 for members (not on free school meals).
£50 for all other children. 50 Places available on a first come, first served basis
Note: Membership can be obtained by attending Friday Club 'Xpress or Sunday Services at Westbourne Park Baptist Church or St. Stephens Church on 3 occasions during the last 3 months.
Email address *
Childs Name *
Your answer
Address *
Your answer
Post Code *
Your answer
Date of Birth *
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DD
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YYYY
School *
Your answer
School Year *
Your answer
Parents Mobile *
Your answer
Name and contact details of parent/carer and one other person we can contact in case of emergency. The named persons can also collect the child *
Your answer
Doctors name and telephone number *
Your answer
Does your child have any medical complaints/allergies/special needs? If yes please specify. *
Your answer
What is the ethnicity of your child? *
What is the faith background of youth child *
*
Yes
No
Does your child receive free school meals?
Does your child speak English as an additional language (EAL registered)?
Does your childe have Special Educational needs (SEN registered)?
Does your child have a statement of Special Educational needs?
Does your child have a disability
I will allow my child/children to participate in any photographs which may be circulated in promotional advertising, local newspapers or childcare magazines.
Once you have read our child care policy below please type your name below to confirm your agreement to abide by it. *
Your answer
Payment - You will get a confirmation text or email one payment is received *
Club ‘Xpress Childcare Policy The childcare policy is an agreement between the parent/carer and the staff of WPFC. If any of the following areas were to be breached, then it may result in the exclusion of the child. Holiday club has 50 places available each day on a first come first served basis Operating times: Holiday Club registration is between 10am-10.30am unless advised otherwise. On collection of child/ren at 3pm parent/carer parent must collect child from staff. If parent/carers fail to collect their child/ren by 3.15pm then the child may not be able to attend on the next occasion. Personal Possessions: WPFC will not be held responsible for the loss of personal items or money. Safeguarding Guidelines: Under the children’s act, staff are obliged to inform social services of any concern regarding a child. If there are any issues surrounding a member of staff the parent/carer are advised to inform the leader in charge, Geoff Biggs. If concerns related to the leader in charge, Westminster Safeguarding Unit should be notified on Tel: 0207 741 5909 Hygiene and health: Staff will not be held responsible for administering children’s medicine. If a child has an inhaler, then they will be allowed to treat themselves under staff supervision. If there are any concerns about a child’s state of hygiene of health, then parent/carers will be informed. By signing this form, you will also be giving permission for staff to seek emergency medical treatment of advice for your child if necessary Children’s behaviour: WPFC works hard to ensure that the children in care remain safe and comfortable. Therefore, if a child’s behaviour becomes unacceptable the parent/care will be contacted to collect their child. Parent/Carer Conduct: All parent/carers are requested to respect the environment of WPFC. If they are abusive to staff, shout or apply any form of physical force against a child or member of staff, then appropriate actions will be taken. GDPR: The general Data Protection Regulation effects the way in which charities keep information. Please see our privacy statement which explains what information we hold about adults and children who have registered with us. It also explains why we hold it, how we protect it, and how you can have information removed from our files. This can be found on our website at www.westbourneparkfamilycentre.org.uk. *
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A copy of your responses will be emailed to the address you provided.
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