Kidz Enterprise LTD Registration Form Confidential – Separate form to be completed for each child, please complete in BLOCK CAPITALS
Child’s Details Name: Religion: Preferred name to be called in club: Ethnicity: Date of birth: Nationality: Gender: BOY / GIRL Languages spoken: Any other name known by: School currently attending: Child’s Main Address: Postcode: Who does the child live with? Who has parental responsibility? If applicable, please tell us when your child arrived in this country: Is there anything we need to know about your child or family (e.g. family setup, court orders or injunctions restricting access)?
Parent/Carer Details 1st Parent/Legal Guardian with parental responsibility 2nd Parent/Legal Guardian with parental responsibility Relationship to child: Relationship to child: Title: Full Name: Title: Full Name: Address if different from child’s: Address if different from child’s:
Postcode: Postcode: Place of work or further education: Place of work or further education: Email: Email: Tel Home: Tel Home: Mobile: Mobile: Work: Work: Invoices - are emailed, please supply your preferred email for the invoice to be sent to Email: Emergency Contact Details (Please provide 3 contact details of suitable adults in addition to the named above ) 1st Contact 2nd Contact 3rd Contact Relationship to child: Relationship to child: Relationship to child: Full Name: Full Name: Full Name: Tel No: Tel No: Tel No: Mobile: Mobile: Mobile: Please note in the event of any of the above being contacted, it would be considered that they have permission to collect your child. In the event that any person named above are unable to pick up my child, I agree that I will inform the club of the change and the named collector will use the following password PASSWORD: Collection Arrangements – Please list below who would be the normal person’s (age over 16yrs) to collect your child Name: Relationship: Name: Relationship: Name: Relationship: Name: Relationship: Parental Consent for Emergency Treatment - In the unfortunate event that my child may need emergency treatment I give permission for any on site treatment to be given by a qualified first aider. I understand that if the emergency services need to be called an appropriate personnel will escort my child to hospital and every attempt will be made to contact a parent/named contact. Should this not be possible I give permission for a Kidz Enterprise personnel to act in the capacity of “loco parentis” in the event of my child needing any emergency treatment that is felt necessary by the medical profession: SIGNED: Medical Information – Please use attached sheet for additional space Doctors Name: Tel No: Surgery Address: Postcode:
Registration form updated - 07/05/2018 Kidz Enterprise LTD Registration Form Confidential – Separate form to be completed for each child, please complete in BLOCK CAPITALS
Child’s Care Information – Please use attached sheet for additional space Preferred interests: Like/dislikes:
Any other information:
Special Dietary Requirements, please include any food & drink preferences and food allergies:
Additional Needs – The information that you give will not affect your child’s space at Kidz Enterprise it will help us to provide the best care for your child when they are attending our club. Allergies: Hearing/eyesight difficulties:
Speech and language difficulties: Other special health issues:
Does your child have or is awaiting a EHC Plan? If so what are your child’s needs:
Parental Permissions – Please note by giving the below permissions, permission will remain until you notify us otherwise in writing I give permission for the duty manager to administer my child Calpol, should my child feel YES / NO unwell while attending Kidz Enterprise I give permission for my child to participate in activities using Snazaroo face paints YES / NO I give permission for my child to participate in activities using make up YES / NO I give permission for my child to participate in activities using temporary hair dye YES / NO I give permission for my child to participate in activities using nail varnish YES / NO I give permission for my child to watch suitable PG films YES / NO I give permission for my child to participate in messy & water activities YES / NO I give permission for my child to be supported by Kidz Enterprise staff to apply sun cream YES / NO I give permission for my child to leave the site under supervision of Kidz Enterprise staff YES / NO Photo Permissions I’m happy for Kidz Enterprise to take photos of my child when participating in club activities YES / NO If you answered YES to the above then please indicate below if you are happy for your child’s photo to be used in the following ways: For activities when recorded on video YES / NO For inclusion in the Kidz Enterprise Newsletter YES / NO For use as evidence of activities YES / NO For use on club display boards YES / NO For use on our monthly birthday display board YES / NO For inclusion within the Kidz Enterprise website: www.kidzenterprise.co.uk YES / NO For inclusion within Kidz Enterprise prospectus and accompanying brochures YES / NO For inclusion within media or other outside organisation publications, which may mean your YES / NO child’s name may be included within the print Please note no personal information and/or identification of any child will be contained in Kidz Enterprise’s website, whether in conjunction with a published photograph or not. Please also note that websites can be viewed throughout t he world and not just in the United Kingdom where UK law applies.
I have read and understood how Kidz Enterprise intends to use “photographic images”. I understand that my decision on whether to give consent will remain valid throughout my child’s time at the club and once they leave, unless I notif y Kidz Enterprise to the contrary in writing. I understand that if I, or members of my family, take photos or video re cordings of any club event, we must obtain prior permission and these will be kept for family use only.
Signed Parent/Carer: Dated: Print Name: Registration form updated - 07/05/2018 Kidz Enterprise LTD Registration Form Confidential – Separate form to be completed for each child, please complete in BLOCK CAPITALS
Addition Information
Signed Parent/Carer: Dated: Print Name:
Registration form updated - 07/05/2018 Kidz Enterprise LTD Registration Form Confidential – Separate form to be completed for each child, please complete in BLOCK CAPITALS
KIDZ ENTERPRISE – Terms and Conditions 1. Children must be collected no later than 6.00pm. CHILDREN COLLECTED AFTER 6.00PM WILL HAVE A PENALTY CHARGE OF £10.00 PER 15 MINUTES OR PART THEREOF. 2. One month’s written notice is required for any change in your child’s sessions or if you wish to give notice for your child to leave. 3. If your child is due to attend a session and for some reason cannot attend you must inform a member of staff as early as possible on one of the provided numbers (01628 665981 or 07973 791419). 4. If you child is due to attend the out of school club and we have not been informed otherwise we will contact you. Repeated occurrences of failure to inform the club of non-attendance will result in your child losing their allocated space, with no refund of monies paid, this is for the safety of your child. 5. Parents must complete a registration form and if registering for breakfast or after school club pay the registration fee of £10.00 per child and the first month’s fees before the child can attend. 6. Parents must identify themselves to the supervisor before the child/ren starts the club. Should arrangements be made at any time for any other adult to collect any children, the supervisor must be informed and where possible, the person introduced to the supervisor. If this arrangement is made by telephone the password from the registration form will be asked for to identify the person collecting the child. Children may only be collected by a suitable adult, older siblings are not permitted to collect children from the club. 7. On arrival for each session, a named adult must accompany all children to the “Registration Table” and sign their child in on the register. We will not accept any child into the club unless a named adult accompanies them. Adults collecting any children must present themselves to a member of staff and sign out the child/ren before escorting them from the club. Please note unfamiliar adults may be asked for photo identification. 8. Unless requested or optional as part of an activity, children should not bring any personal toys, games or valuable items to the club. 9. Invoices will be sent out monthly which must be paid in full by the first day of the month. Failure to pay your invoice may result in your child’s space being cancelled. Holiday club bookings must be paid at the time of booking or within 7 days, all bookings must be paid by the 1st day of the club, bookings unpaid by the 1st day will be automatically cancelled. 10. Any invoice outstanding beyond this period will be referred to Daniels Silverman Limited and will be subject to a surcharge of 20% plus VAT to cover the collection costs incurred. This surcharge together with all other charges and legal fees incurred will be the responsibility of the customer and will be legally enforceable. 11. If your child cannot attend for a booked session the following will apply: 12. Breakfast/after school club – Payment must be made in full other than if the child cannot attend due to a family holiday authorised by the school or school trip of 5 days+, during term time a 50% retainer must be paid, day school trips will be charged at full rate. During holiday club the following will apply - If a cancellation is made more than 14 days before the holidays commence, a full refund/transfer will be received, apart from £10.00 to cover admin costs. Places cancelled within 14 days of the holidays commencing or once the holidays have started will only receive a refund/transfer if the places can be resold, apart from £10.00 to cover admin costs. Booked holiday club places may not be transferred to another day once the holiday has commenced. 13. Kidz Enterprise policies must be adhered to at all times; failure to comply with any policy may result in an exclusion being issued. 14. Respect for, and proper use of all property, equipment and the premises is essential and must be maintained by all persons (child and adult) at all times. If necessary any child acting inappropriately, abusing property, equipment or premises will be spoken to with a parent/carer present. Any damage to property or equipment whilst attending the club must be reimbursed by the parent/carer; failure to pay for any damage caused may result in the child being excluded from the club. If this should occur no refund of monies paid will be given. When using the breakfast/after school club parents must use the Cippenham Primary School entrance with car park facilities available between 7.30am-8.00am & 5pm-6pm, outside of these times parents must find alternative parking. During holiday club parents must use the Cippenham Infants entrance following the correct speed limit at all times. 15. Parents/carers or nominated adults are not to smoke within the school premises. 16. While attending the club children must wear suitable clothing/footwear (we encourage a change of clothes for sport activities and shorts under dresses), during hot weather children attending the club are encouraged to wear a suitable sun hat and bring sun lotion. 17. Kidz Enterprise LTD cannot be held responsible for any lost or damaged personal belongings while attending the club. 18. All information exchanged by any person involved with the clubs must be kept strictly confidential. 19. Parents/Carers must inform us of any changes to contact details, including new telephone numbers, failure to keep us informed of change of contact details may result in your places being lost. 20. Should any of the above Terms & Conditions not be adhered to, it may result in expulsion from the club. If this should occur no refund of monies paid will be given. 21. THE SUCCESS OF KIDZ ENTERPRISE OUT OF SCHOOL CLUBS DEPENDS ON CO-OPERATION AND SHARING BETWEEN ALL THOSE INVOLVED. PARENTS/CARERS SHOULD ADDRESS ANY COMMENTS THEY WISH TO MAKE TO THE ORGANISERS. 22. These terms and conditions supersede any previous terms and conditions. 23. During holiday club sibling discount only applies to brother/sisters of the 1st named child. 24. During holiday club parents will be notified of activities in advance and what clothing or accessories will be needed. 25. During holiday club it may not be possible to wait for children arriving late on a trip, no refund will be given for late arrivals. Registration form updated - 07/05/2018 Kidz Enterprise LTD Registration Form Confidential – Separate form to be completed for each child, please complete in BLOCK CAPITALS
In addition to our Good Behaviour Policy & Anti-Bullying Policy the following applies to anyone using Kidz Enterprise Behaviour by any person ‘on or off site’ considered by the organisers to be unacceptable and inappropriate will not be tolerated. These include smoking, alcohol, drug abuse, solvent abuse, bad or offensive language, bullying and any other situation, which could cause and/or distress. Continuous disruptive and unacceptable behaviour by any person (child or adult) will be reported to the organisers by the supervisor. This will be followed by discussion with other staff and the person(s) concerned. Any damage caused by any person(s) while attending a Kidz Enterprise activity that is considered by the supervisor or organiser to be unacceptable behaviour will need to be reimbursed by the parent/carer of the child concerned. The organiser reserves the right to exclude any person from the activity and or the site, should such incidents occur. Operational Plan Kidz Enterprise has a full range of policies and procedures for parents/carers to view at any time either via our website www.kidzenterprise.co.uk or within the club. Please make time to view these as signing the contract of agreement states that you are willing to abide by them.
CONTRACT OF AGREEMENT Before signing this form please read and understand the terms & conditions and explain them to your child, please understand that should anyone contravene any of the terms & conditions, it could result in exclusion from the club with no refund of monies paid.
I agree to reimburse Kidz Enterprise for any damage caused by my child, myself or nominated person while present at the club. I understand that any decision made by the leaders is final.
I understand that persistent late or non-payment of fees will jeopardise my child’s continued attendance at the club.
I agree to the terms and conditions of Kidz Enterprise and understand that by signing below enters me into a contract with Kidz Enterprise LTD, I confirm that all the information is correct and understand that should any personal details change I will notify Kidz Enterprise at my first opportunity.
Signed Parent/Carer: Dated: Print Name:
Office Use: Visit Date: Start Date: School: Year: Teacher:
NB – Should the information contained in this document be held on computer, any item of personal data will be subject to the Data Protection Act 1998
Registration form updated - 07/05/2018