Ashbridge Holiday Care Admissions | Ashbridge School & Nurseries

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Full Name of Child *

Date of Birth (DD/MM/YYYY) *

Gender *

Name & Age of Siblings

Personal Information

Ethnic Background

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.

Other Information

Medical Information

Name of Childs Doctor *

Telephone Number *

Details of Medical Condition, Disabilities, Allergies etc* *

No special requirements

No special requirements

Details of any Dietary Needs *

No special requirements

No special requirements

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

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

Name *

First

Last

Is this Person Legally Responsible For The Child? *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Phone *

Email Address *

Place of Work *

Work Phone Number *

Name (Second Contact) *

First

Last

Relationship to Child *

Address (Second Contact) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Phone *

Email Address *

Place of Work *

Work Phone Number *

Relationship to Child *

Designed Bill Payer

Select Bill Payer

Name *

First

Last

Email *

Contact Number

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 at least a week in advance off attendance.
Notice of cancellation of booking is required in writing by noon on the Friday prior to the week of booking or full fees will be payable.
The school reserves the right to change or amend regulations, policies and procedures as necessary. A fee review also takes place annually.
Outings may take place away from holiday care. I/We give permission for staff to take my/our child on outings.
I/we give permission for staff to call for emergency assistance or take my/our child to hospital if necessary.
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.
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 confirm that we have read and understood the contents of the Holiday Care Enrolment Form and the attached Terms and Conditions. *

Address etc* Medical

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 holiday care. *

• I/We agree to be bound by the Terms and Conditions which consist of this Holiday Care Enrolment Form, the Holiday Care regulations and terms and conditions set out below and any of the school’s policies and procedures which are in place from time to time. *

We confirm that the details set out in this Holiday Care Enrolment Form are true and accurate in all respects. *

I/We give permission to the school, its employees and agents to share information relating to my/our child with Children’s Social Care and other agencies responsible for protecting children as the school deems appropriate. *

I/We wish to apply for my/our child to attend from:

Signature *

Clear Signature

Name: *

Date *

Signature *

Clear Signature

Name: *

Date *

Previous Nursery/School(s) Attended

How did you hear about us?

Terms *

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.

Understand *

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 application has been reviewed and approved by a representative of Ashbridge Independent School and Nurseries.

School Holiday Care Admissions

Personal Information

Medical Information

Contact Information

Parent/Guardian

Designed Bill Payer