Prep Summer Holiday Activity Course 2017 – The Hawthorns Sports Centre

Child's First Name:*

Child's Surname:*

Child's Age:*

WEEK 1: Monday 24th – Friday 28th July 2017

WEEK 2: Monday 31st July – Friday 4th August 2017

Full Week (£140):

Daily attendance below if not attending for the duration of the week: (£35 per day)

Chose one option only:

(other activities such as swimming will be offered in the afternoon)

Full Week (£140):

Daily attendance below if not attending for the duration of the week: (£35 per day)

Chose one option only:

(other activities such as swimming will be offered in the afternoon)

Parent/Guardian First Name:*

Parent/Guardian Surname:*

Address*

Street Address Address Line 2 City County Postcode

Home Tel:*

Email*

Please give details of any allergies, illnesses, special needs, dietary restrictions, etc

Method of payment

(All child care voucher payments must be cleared and received prior to the first day of attendance)

Terms and Conditions

I will notify the Activity Course Leader of any specific medication that may need to be administered to my child
I will inform the Activity Course Leader of any changes or updates to any information relevant to the details on this form
Will your child require access to medication during the course (this includes Asthma Inhalers).
Please state if a sibling is attending the Pre-Prep or Prep School Activity Course.

(If yes a 10% discount will be applied for full week bookings)