Templesprings Holiday Club Registration Form

Templesprings Holiday Club Registration Form
Changes to our Terms and Conditions - PLEASE TAKE NOTE

Here at Templesprings Childcare Services, we are dedicated to providing our services in a way which ensures the safety of our staff, children, and families.

The Covid-19 pandemic has impacted many businesses, ours included. This requires us to adapt to the ever-changing government policies and be resilient in our outlook going forward.

To this effect, we have made changes to our breakfast, after-school, and holiday club provisions. We have introduced additional terms and conditions which came into effect in 2020.
- We will operate a Pay As You Go (PAYG) Childcare service provision . This means that:
  - We will no longer enter into contract with you for the provision of childcare services.
  - You will need to complete a new application form to register for this PAYG service
  - You will need to read and sign the Coronavirus / Covid-19 Agreement
  - You will still need to read and comply with our Policies and Procedures including the new Covid-19 Policy
  - You will be given a copy of our Safe Practice Guidance to talk through with your child and to ensure both of you adhere to our range of protective measures
- There is a non-refundable one-off administrative fee of £35 to be paid with the registration form.
- We will operate a bubble system. Due to current restrictions, additional cleaning requirements of the facilities and to retain the small groups of children within the guidance requirements (bubbles), we cannot take ad hoc one day bookings .
- To ensure we can keep children within their bubble groups throughout the week, we are offering the following options and permutations ONLY :
  - 2-Sessions Bubble (Bookings on Tuesday and Wednesday ONLY)
  - 3-Sessions Bubble (Bookings on Tuesday, Wednesday, and Thursday ONLY
  - 5-Sessions Bubble (Bookings on Monday to Friday ONLY)
  - Please select which Sessions you wish to register for Holiday Club (HC)
- Due to Covid-19 we are offering a restricted service, opening and closing times. Unfortunately we are unable to provide extended hours.
  - [HC] Holiday Club Full Day starts at 8:00pm - 5:00pm
  - All children MUST be collected PROMPTLY no later than 5:00pm
  - A late charge of £5.00 per minute will be applied to your account. This must be paid before your next booked session, otherwise we are unable to accept your child the next day.
- Payments are in advance of the sessions
  - The cost is £55 per session
  - Please note that Full charges will still apply for any non-attendance as per our fees policy. There are no refunds under no circumstances
- We will restrict the number of visitors to our centre, including parents who will be encouraged to contact us by phone or email in the first instance rather than coming in to the centre.

	Holiday Club (8am - 5pm)
2-Sessions Bubble (Bookings on Tuesday and Wednesday ONLY)
3-Sessions Bubble (Bookings on Tuesday, Wednesday and Thursday ONLY)
5-Sessions Bubble (Bookings on Monday to Friday ONLY)

Parent/Carer Information
Name of 1st Parent/ Carer *
E-mail *
example@example.com
Relationship to Child: *
E.g. Mother, Father, Carer
Address *
Mobile No: *
Please complete Parent/Carer Information for Second Parent if applicable
*Name of 2nd Parent/ Carer
E-mail
example@example.com
Mobile No:
Relationship to Child:
E.g. Mother, Father, Carer
Address (Please ONLY fill out if different from Parent 1’s address)
Collections and Emergency Contact
Collection: Please state the person who can collect your child if different from the Parent/Carer Please note that we will only release your child to authorised persons over the age of 18 if their details are provided. Password System - We request that you create a password on your account. Please ensure the password is unique and only given to the persons who you will allow to collect your child. It is the responsibility of parents/carer to contact us by email and inform us if someone else will be collecting your child *

Yes - I give permission for the person(s) listed below to collect my child(ren)
Name *
Mobile No: *
Relationship to Child: *
E.g. Mother, Father, Carer
Password *
We will ask the person for this Password before we release your child to them
Additional Persons - Name
Mobile No:
Relationship to Child:
E.g. Mother, Father, Carer

Medical Details
Does your child have any medical conditions and/or additional needs? *

Yes No
This information is essential in order for us to provide the relevant support for your child. If YES, please give details
Information such as whether your child is currently receiving any treatment from a Doctor or Hospital; names and dosage of any medication; any major illnesses or operations that your child has had in the past 3 years. Please Note: ALL ASTHMA SUFFERS MUST CARRY INHALERS during the event.
Does your child have any allergy or special dietary requirements including religious observations? *

Yes No
If YES, please give details
Name of GP/ Doctor: *
Tel No of Surgery: *
Address of GP/ Doctor: *

Covid-19 Agreement & Consent Form
1) Coronavirus / Covid-19 Agreement

I acknowledge the contagious nature of Coronavirus and that the latest government guidance recommends practising social distancing and a range of other protective measures.

I recognise that Templesprings Childcare Services has put in place a series of protective measures to reduce the risk of Coronavirus transmission within the setting, but I accept that Templesprings Childcare Services cannot guarantee that my child will not be exposed to Coronavirus whilst attending the club.

I understand that I must follow the procedures set out by Templesprings Childcare Services when dropping off and collecting my child from the setting.

We have developed our Safe Practice Guidance to complement our existing Parent’s Handbook. The Safe Practice Guide outlines how we are successfully integrating the new guidelines to ensure Templesprings Breakfast & After School Club is an engaging Safe Space for all.
I understand the importance of vigilance regarding Coronavirus symptoms as a keystone of preventing the transmission of the virus to other children, staff and parents. Accordingly, I confirm all the following are true: *

My child is not experiencing any Coronavirus symptoms such as cough, shortness of breath or difficulty breathing, fever, muscle pain, headache, sore throat, or new loss of taste or smell. My child has not tested positive for Coronavirus, or been advised by NHS Test & Trace to self-isolate. My child has not been in contact with anyone in our household who has Coronavirussymptoms, or who has been advised by NHS Test & Trace to self-isolate My child has not travelled abroad to any country other than those identified as‘safe’ by the government within the last 14 days. My child is capable of following the club rules relating to protective measures,such as not mixing with children in other bubbles, washing their handsregularly, coughing and sneezing into a tissue and disposing of it safely, andnot touching other children. I understand that if they are unwilling to followthe rules they may not be allowed to attend future sessions If any of the above circumstances change, I will not bring my child in to the cluband will notify the club manager immediately.
2) Photography & Video Consent

From time to time we will take photographs and video recordings of the children who attend. These photographs are used for on-going recording of our curriculum and for children’s individual development records. They are stored on our computer whilst your child is with us. The photographs are used for display and for your child’s records within the setting. We may also use these images for training, publicity or marketing purposes on our website and other mediums. We will not use the images taken, or any other information you provide, for any other purposes.

We would always seek your written consent for any use.
Photography & Video Consent *

I agree to allow Templesprings Childcare Services to take videos and photographs of my child(ren) and use for the purposes described above. I do not agree or give consent

Holiday Club Fees
A non-refundable administration fee of £35 is required to register at our setting.

Please follow instructions to make payment.

Childcare Fees *

Administration Fee £ 35.00 GBP

Non-refundable administration Fee. This allows us to setup your profile on our system. Once setup, you can book further sessions via the Portal.

Total £ 0.00 GBP

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Terms and Conditions - Signature
Signature
I HEARBY ACKNOWLEDGE AND SIGN THE REGISTRATION FORM. I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE. *
Should be Empty:

Templesprings Holiday Club Registration Form

Medical Details

Covid-19 Agreement & Consent Form

Holiday Club Fees

Terms and Conditions - Signature