Childcare sessions required form

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Child's name *

First

Last

Child's date of birth *

Parent / Carer's name *

First

Last

Phone number *

Email *

Postcode

Start date *

Monday *— Select Choice —9am – 3pm9am – 12pm12pm – 3pmNot required

Tuesday *— Select Choice —9am – 3pm9am – 12pm12pm – 3pmNot required

Wednesday *— Select Choice —9am – 3pm9am – 12pm12pm – 3pmNot required

date require name

Thursday *— Select Choice —9am – 3pm9am – 12pm12pm – 3pmNot required

Friday *— Select Choice —9am – 3pm9am – 12pm12pm – 3pmNot required

Do you require Breakfast Club?

• Monday 8 – 9am
• Monday 8.30 – 9am
• Tuesday 8 – 9am
• Tuesday 8.30 – 9am
• Wednesday 8 – 9am
• Wednesday 8.30 – 9am
• Thursday 8 – 9am
• Thursday 8.30 – 9am
• Friday 8 – 9am
• Friday 8.30 – 9am

Breakfast is served between 8 – 8.30am. Do you require breakfast?

• Yes
• No
• n/a

Do you require After School Club

• Monday 3 – 4pm
• Monday 3 – 5.20pm
• Tuesday 3 – 4pm
• Tuesday 3 – 5.20pm
• Wednesday 3 – 4pm
• Wednesday 3 – 5.20pm
• Thursday 3 – 4pm
• Thursday 3 – 5.20pm
• Friday 3 – 4pm
• Friday 3 – 5.20pm

Snack is available at 4.30pm. Do you require snack?

• Yes
• No
• n/a

Submit

We strive to meet your childcare needs, though places can be limited.

We’ll be in touch to confirm or discuss your requested sessions.