Chorlton Park out of School Hours Scheme Booking Form

BOSH

WHITHoliday Club Booking Form

Date: / Tuesday 26th- Friday 29thMay 2015

Playscheme Details

The Holiday Club is run by BOSH Ltd. and staffed by qualified playworkers. The Holiday Club will be based at <To be confirmed>for the week. It is open to all children aged 3 – 11 (Nursery-Year6).

The core hours are 8.30am–5.30pm, extended hours (7.45am-6.00pm) are available for an extra £2.50 and need to be booked in advance.Please ensure that children are dropped off and collected within your booked times. Light refreshments are provided mid-morning and mid afternoon, but children are asked to bring a packed lunch. Please note that clothing should be suitable for messy play and arts & crafts and that wellingtons & coats should be provided in case of wet weather.

Fees

Fees are £23.00 (£25.50 for extended hours)per first child, £20.50 (£23.00 for extended hours) per subsequent child per day; £14.75 (£17.25for extended hours) per child per half day (places permitting).N.B. When booking a full Week the fifth day is HALF-PRICE.

Payment should ideally be made directly to our bank account: BOSH Ltd. 09-06-66 42534902, or by eVoucher.

N.B. Cheques will need to add £1.07 to the total amount in order to cover the cost of processing.

PARENT(S)/GUARDIAN(S):

Name: / 1 / 2
Address:
Postcode:
Email:
Telephone: Work:
Mobile:

(these should be phone numbers where we can contact you during Holiday Club hours).

CHILD(REN) for whom places are required:

Full Name(s) / Gender
(M/F) / Date of Birth / Places Required / Extended Hours Required
1
2
3
I enclose a cheque made payable to BOSH Ltd. for: £ ......
N.B. Please add £1.07 for each cheque to be processed. / I have transferred £......
to the BOSH bank account by BACS. / Please add the cost of my holiday club places to my BOSH Account, My BOSH Reference is:
WHGS/BOSH ______

MEDICAL INFORMATION Details of Doctor:

Name:
Address: / Telephone:

Please give brief details of any medical problems/known allergies/dietary restrictions, etc.

I give my consent for BOSH staff to act on my behalf in an emergency. I also give my consent for my child to go off the premises used by BOSH, supervised by an appropriate adult. Whilst every care and precaution will be taken BOSH Ltd. cannot be held responsible for any accidents which may occur.

Signed...... ……………………………...... Date......

(Parent/Legal Guardian)

PLEASE RETURN THIS FORMto:-

BOSH Ltd.,Unit 8670, P.O. BOX4336, Manchester, M61 0BW. For general enquiries please ring free phone:0800-756-6667 to check availability, but please note that places are very popular & early booking is advisable.

PLEASE NOTE: A receipt & confirmation of your place(s) will be sent to you before the start of the Holiday Club.