Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Parent Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Early Years Provision *

Please indicate your requirement

Early drop-off (7:30am-8am)

Mornings (8:00am - 11:30am)

Lunch Club 11:30-12:30

Afternoons (12:30pm - 3:30pm)

All day 8:00am - 3:30pm

All day 8:00am - 6pm

Afterschool 3:30pm - 6pm

N/A

Primary School Club *

Please indicate your requirement

Early Drop-off (7:30-8am)

Breakfast (8am - 9am)

After-school until 6pm

N/A

Holiday Club *

October Half term 1 - w/c 21st October 2024

October Half term 2 - w/c 28th October 2024

Christmas wk 1 - w/c 16th December 2024

Christmas wk 2 - 23rd/24th December 2024

Christmas wk 3 - w/c 30th December 2024

February Half Term - w/c 17th February 2025

Easter wk 1 - w/c 31st March 2025

Easter wk 2 - w/c 7th April 2025

Easter wk 3 - w/c 14th April 2025 (Mon-Thurs)

Easter wk 4 - 21st/22nd April 2025

May Half Term 1 - w/c 26th May 2025

May Half Term 2 - w/c 2nd June 2025

Summer wk 1 - 9th/10th/11th July 2025

Summer wk 2 - w/c 14th July 2025

Summer wk 3 - w/c 21st July 2025

Summer wk 4 - w/c 28th July 2025

Summer wk 5 - w/c 4th August 2025

Summer wk 6 - w/c 11th August 2025

Summer wk 7 - w/c 18th August 2025

Summer wk 8 - w/c 25th August 2025

Summer wk 9 - w/c 1st September 2025

N/A

Ad-Hoc Childcare Service *

Please indicate if you would be interested in registering your child for access to the ad-hoc childcare service.

Yes

N/A as enrolling in Pre-school

N/A as enrolling in Wraparound

Funding *

Please select as appropriate

Free Early Years Education for Two Year Old's

Universal 15 Hours Early Year's Education

Extended 15 Hours Entitlement

Unfunded

Requested Start Date *

MM

DD

YYYY