Parent/ Guardian Details

First name

Relationship to child

Contact Number

Email

Child Information

Full Name

Date of birth

Day

Month

Year

Age

School Attended

Year Group

Teacher’s Name (if known)

Afterschool Club – Days & Pick-Up Times

Please select the days your child will attend Afterschool Club.Pick-up times vary by day, so please read the information below carefully before choosing your sessions.

Pick-up times:

Tuesday & Thursday: 6:00pm
Monday, Wednesday & Friday: 6:30pm

Preferred Start Date

Day

Month

Year

Breakfast Club is currently operating a waiting list.

Sessions will begin once there is sufficient demand to run the club sustainably.We will contact families on the waiting list in order as soon as places can be confirmed.

Drop-off time: 7:30am until school start time.

Preferred Start Date for Breakfast Club - Waiting list

Day

Month

Year

Health, Dietary & Additional Needs

Allergies / Dietary Requirements

Medical Conditions / Medication

Special Educational Needs (SEN) / Additional Needs

Any other information to help us support your child

Doctor’s Name & Surgery

Emergency Contact (if different)

Emergency Contact Number

Childs Interests

Other interests

Payment information

Registration Fee: £25 (This fee will be deducted from your first months payment)

Bank Transfer Details:

Account Name: KidzPlay Early Rise

Bank: Monzo

Sort Code: 040003

Account Number: 44815171

Payment Reference: Your Child’s Name

Once payment is received, your space will be confirmed and your enrolment number issued. You will receive your welcome pack and confirmation email once the club opening date is announced.

Declaration

I confirm that the information provided is accurate. I understand that:

This form secures my child’s Early Bird enrolment at KidzPlay Early Rise (subject to availability).
I will pay the registration fee of £25 per child / £30 per household to confirm the space.
No additional payments will be requested until just before my child’s start date.
My first month’s fees will be payable in advance of my child starting and will include the Early Bird discounted rate.

Early Bird Registration Form

Parent/ Guardian Details

Child Information

Afterschool Club – Days & Pick-Up Times

Health, Dietary & Additional Needs

Childs Interests

Payment information

Declaration