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Chillzone Before and After School Club Registration Form - September 2024

Please find below our Chillzone Before and After School Club registration form for September 2024.

Please note that we can only accept bookings for pupils in Reception through to Year 6.

If you have any questions, please contact the school office on 01782 235577.
1.Child/rens Name/s
2.Date of birth/s
3.Please tick which Year Group your child/ren will be in in September 2024
4.1st Parent/Carer Details
5.2nd Contact Information
6.Medical Contact Information
7.Childs Medical Information/Conditions
8.Special Requirements i.e. dietary, special needs (physical or other)
9.Do you provide consent for (Tick all that apply);
10.Do you require morning sessions? (7.30am - 8.45am) £4.50 per session (Tick all that apply)
11.Do you require PM Session (3.15pm - 4pm) £4.50 per session (Tick all that apply)
12.Do you require PM Session (3.15pm - 6pm) £9 per session (Tick all that apply).
13.Can your child walk home alone after Chillzone? (This is only possible for Year 6)
14.By submitting this form I agree that I have read and agree to the terms of Chillzone - our terms can be found at; Burnwood Website(Required.)
15.Please provide a password to be used for collection of the child