Register Your Child

This Form Is To Register for The Wykeham Centre

    Child's Details

     


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    date_range


    place


    my_location


    wc


    date_range


    group


    school

     
     

    Child's Medical Info

     


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    phone


    place


    my_location


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    Parent/Carer 1 (Bill Payer) Details

     


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    person


    email


    phone


    place


    my_location

     
     

    Parent/Carer 2 Details


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    person


    email


    phone


    place


    my_location

    Parental Responsibilities

    Please Select 'YES' or 'NO'

    Does parent/carer 1 have parental responsibility?

    YESNO

     
     

    Does parent/carer 2 have parental responsibility?

    YESNO

     
     

    Does anyone else have parental responsibility for this child?

    YESNO

     
     

    If 'YES' Please provide details below


    person

    Authorised Collectors

     

    Details of other person authorised to collect in absence of parent(s)*


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    email


    phone

    Security

    In the event of somebody else collecting your child we require a password to release your child.

    All staff are trained to ask for this password if they do not recognise the person collecting your child.


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    Emergency Contact Details - Please Provide 2 People

     

    Person 1


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    phone


    email


    place


    my_location

     

    Person 2


    account_circle


    phone


    email


    place


    my_location

    Child's Preferences & Permissions

    Is your child permitted sweets/cakes?

    YESNO

     
     

    Are you happy for your child to have party foods on birthdays and other festivals?

    YESNO

     
     


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    Booking Pattern & Payment

    PARENTS MAY CHOOSE ADHOC DAYS FOR BREAKFAST AND AFTER SCHOOL CLUB

    Breakfast Club Booking Pattern

    Breakfast Club - 7.am – 8.20am @ £5.50 per session

    MonTuesWedsThursFri
     
     

    After School Club Booking Pattern

    Please tick required days

    MonTuesWedsThursFri

     
     

    After School Club Collection Time

    Please select collection time

    4pm4:30pm5pm5:30pm6pm7pm

     
     

    Payment Options

    Please select BACS Weekly/Monthly or Vouchers

    BACS MonthlyBACS WeeklyVouchers

    N.B. By selecting a paymet option you are agreeing to the following terms;

    - Payments to be made in advance for pre-booked contracted days

    - Administration fee of £25.00 to be paid on application

    - Refundable Deposit of £100.00 payable which is refunded upon 2 weeks paid notice of termination of contract

     
     

    Activity Terms & Permissions

    Some of the routine activities of the club may involve physical play activities, visiting parks, short trips & day trips.

    Minor accidents will be expected through the very nature of participating in play.

    All activities are risk assessed and properly supervised.

    For your child to take part in these activities you must give your permission below;

     
     

    I agree to my child taking part in the routine activities

    YESNO

     
     

    I agree to make payment for outings & provide spending money if required.

    YESNO

     
     

    I agree to the Co-ordinator or Manager to act appropriately in an medical emergency:

    YESNO

     
     

    Application of Sunscreen

    Children love to play outside in the sun, but sunburn in childhood increases the risk of developing skin cancer in later life.

    Please select whether you will be using the Club's or providing your own sunscreen

    I am happy for my child to use the sunscreen provided by the Club.I will provide a bottle of sunscreen labelled with my child’s name for use at the Club.

     
     

    Photography & Video Consent

    In-house Observations

    YESNO

    In-house wall displays

    YESNO

    School Club Website using facial images

    YESNO

    School Club Website (Non-facial)

    YESNO

    School Club Facebook page (Non-facial)

    YESNO

    School Club Facebook using Facial images

    YESNO

    Promotional literature booklets

    YESNO

    Local press releases

    YESNO

     
     

    General Data Protection Regulation Compliance

    In order to meet our requirements under GDPR we will ensure that parents are provided with our privacy notice and data sharing agreement.

    We confirm that we will not share or use your data for other purposes other than what is outlined.

    *Our GDPR is available by clicking here (opens in a new window).

    Please confirm that you accept the privacy notice and data sharing agreement and that you give your permission for us to contact you regarding relevant matters.

    I accept the privacy notice and data sharing agreement

    YESNO

     
     

    Terms & Conditions

    *Our terms and conditions are available by clicking here (opens in a new window).

    I have read the terms and conditions and agree to them

    YESNO