CARE CLUB BOOKING FORM - COUNTESS WAY SPRING TERM (3rd January - 23rd March 2018)

(Places are given on a first come, first serve basis) Childs Name: _________________________________________________________ Age: ____________ Class_____________ Please note: Only tick the care club option between 4.30pm and 6.00pm if you have booked and paid for your child to attend an activity club.

Please tick the relevant boxes

Breakfast Club 8.00 - 8.20am

£3.50 per session

Please enter any dates you do not need your

child to attend breakfast club

Care club 3.30pm - 6.00pm

£12.50 per session

Care Club 4.30pm - 6.00pm

£8.00 per session

Please enter any dates you do not need your

child to attend care club

Total

Monday x10 weeks

Tuesday x 10 weeks

Wednesday x 11 weeks

Thursday x 11 weeks

Friday x 11 weeks

Total Cost for ALL Sessions

(Please add this amount to ParentPay or send Vouchers

Please sign to confirm you wish to book your child into the above Care Club sessions for Spring Term and that you have read the care club full terms and

conditions found on the school website. You will be charged for all clubs requested for the full half term to your parentpay account, unless you have stated dates you do not need your child to attend the club. Please see our Terms and Conditions regarding cancellations.

BREAKFAST & CARE CLUB SESSIONS SHOULD BE PAID FOR PRIOR TO YOUR CHILD ATTENDING. Parents Signature________________________________________________________________________________Date___________________________________

For further information or queries please contact careclub at careclub@brooklandsfarm.milton-keynes.sch.uk or call 01908 760081 (option 2)