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


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group


school

 
 

Child's Medical Info

 


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phone


place


my_location


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edit


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edit


edit

 
 

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


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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