Holiday Care in Preston

Holiday Care Enrolment Form

PERSONAL INFORMATION

(Please include details of ethnic background and if English is an additional language, please state what is the first spoken language and details of any other languages spoken.)

MEDICAL INFORMATION

Address:

2. Details of Medical Condition, Disabilities, Allergies etc:

4. Special requirements regarding food (Please state reason on medical condition or religious grounds only):

*Please note that Allergen information is available on request.

CONTACT INFORMATION

(Please include name, address and ALL appropriate telephone numbers (landline & mobile) and email addresses and ensure all contacts consent to their personal details being shared with us.)

PARENT/GUARDIAN 1

Address:

PARENT/GUARDIAN 2

Address:

THIRD CONTACT

Address:

I/WE REQUEST A PLACE FOR MY/OUR CHILD TO ATTEND HOLIDAY CARE AND UNDERSTAND THAT:

A non-refundable registration fee of £25 paid by cash, cheque, card or bank transfer is required to secure the place.
Fees are due and payable in advance.
Notice of cancellation of booking is requested in writing or full fees will be payable.
Ashbridge reserve the right to change or amend regulations, policies and procedures as necessary. A fee review also takes place annually.
I/we give permission for staff to call for emergency assistance or take my/our child to hospital if necessary.
I/we understand that access to the following policies, procedures and protocols is available through the company website or as hard copy on request: Admissions, Behaviour, Exclusion, SEN, EAL, Curriculum, Anti-Bullying, Health and Safety, First Aid, Complaints and Privacy Notice. In addition, the latest inspection reports are also available.
I/We agree to comply with the Regulations, Terms and Conditions of Ashbridge School and Nursery Ltd.
I/We have read, understood and completed all the details set out in this enrolment form as required at registration and attach a copy of my/our child's Birth Certificate.
I/We give permission to Ashbridge to share information relating to my/our child with Children’s Social Care and other agencies responsible for protecting children.

Outings may take place away from holiday care. I/We give permission for staff to take my/our child on outings.
YesNo
I/we give permission for photos/videos to be taken of my/our child for promotional purposes including printed materials, website, social media and local and national press, whilst attending Ashbridge or at a later stage.
YesNo

BY SUBMITTING THIS APPLICATION YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS WHICH CAN BE VIEWED HERE AND BY ASHBRIDGE REGULATIONS, POLICIES AND PROCEDURES.

I understand the completion of this form does not guarantee a place at the holiday care, and that a place will not be offered until the registration fee of £25 has been paid and the application has been approved by a representative of Ashbridge Independent School and Nursery.