Holiday & Ad-Hoc Form

Please fill in all fields, if not applicable please state N/A

Choose Period:

Which period are you requestingIn service day full day careEaster holidayMay DaySummer holidayAd hoc

Child’s Name:

Child’s School Attending:

Child’s Class:

Parent/Carer Name:

Parent/Carer Telephone:

Parent/Carer Email:

Do you consider your child to have any additional support requirements/ accessibility needs /medical condition? (if yes, I/we will complete a care plan/administration of medication paperwork when required)

YesNo

Does your child have a sibling(s) that currently attends Time-Out Club?

YesNo

Has your child attended Time-Out Club previously?

YesNo

I acknowledge that completing this enrolment form does NOT guarantee a placement

I accept

I understand that by completing this online form, I will also be required to complete a more detailed enrolment/personal plan form and confirm my acceptance of all policies, procedures, and GDPR requirements as outlined in the parent/carer handbook, prior to my child joining Time-Out Club.

I accept