Sarratt C of E School Friday Football Booking Form

Sarratt C of E School Friday Football Booking Form Spring Term (2022/2023)

Please complete the booking form below to secure your child's place for this Xtra Time After School Sports Club.
Every Friday from 13th January - 24th March (10 weeks)

Year 1 to Year 6 - boys & girls

ONLY 32 SPACES AVAILABLE

Prizes, trophies, medals, and certificate to be won!

10 Week block £80.00 (this session runs from 3.25pm - 4.25pm)

Please note: The coaches will always aim to be at the school 15 minutes before every session starts. Our session are on the school site. Registers are emailed to the school office which are then passed on to your child's teachers.

Late booking fee: £5.00 (applied after booking deadline 11/01/2023)
What would you like to book?*

I would like to book Football (Fridays)
Child's Full Name:*

First Name Last Name
Child's School:
Child's Year:*
Child's Class:*
Medical Condition(s):*
EpiPen.
Further on from our 1st Aid Training in September 2021, it has been advised that we should administer a second dose of EpiPen 5-15 minutes after the first dose if the child does not feel better. It also allows critical time for the ambulance crew to get to the session. If your child requires an EpiPen, your child must have TWO EpiPen's with them at all times. By ticking this box you are confirming that you will send your child in with two EpiPen's. Failure to do so will result in Xtra Time sending your child to the school office. Your chilld will not be able attend the session until they have two EpiPen's. This is to safeguard your child and Xtra Time Staff.

I confirm that I have read and understand the above.
Does Your Child Have Any SEN:*
Does your child have any SEN (Special Educational Needs)?
Details of Medical Condition(s) / SEN:*
Please provide details of any medical conditions.and/or Special Additional Needs. For example:Asthma and/or ASD etc
Parent/Guardian Name:*

First Name Last Name
Parent/Guardian E-mail:*
Emergency Contact 1:*
Mobile number
Emergency Contact 2:*
Mobile number
Full Address:*

Street Address

Street Address Line 2

City County

Postcode
Collected By:*
Name of person collecting your child
Relationship To Child:*
What is their relationship to your child
Security Password:*
Chose a security password of your choice that'll be used if somebody else collects your child
Sub Total £
Late booking fee

Applied £5.00
Late Booking Fee £
Late booking fee applied after deadline
Grand Total:
Payment Method:*

Bank Transfer - Please follow the instructions belowChildcare vouchers (please select your provider below)
Childcare Provider:*

CO OP - 85116843EDEN RED - P20733006KIDDIVOUCHERS - 100418CARE4 - 18475662BUSYBEES - XTRA TIME KIDZ CLUB - HolywellCOMPUTERSHARE - 0020197568RG CHILDCARE - 97926708410FIDELITI - XTR001CFAIRCARE - XTHO0218TAX FREE CHILDCARE SCHEME - Holywell Ofsted No: EY444153ENJOY BENEFITS - WD18 9QDSODEXO - 850954OTHER - Please provide details in additional comments box below
*Please note: We no longer accept online payments through our website. Bank details have been provided below to secure your child's place.

Please make your booking payment in full to the account below:

1st Touch Coaching / trading as Xtra Time Sports Services

Sort Code: 09-01-29
Account Number 33376844

It is soley the parent/carers responsibilty to make the booking payment in full. If your child's payment has not been made in full to the account specified above, we cannot secure your child's booking.

Once you have made your payment in full, please include your payment reference and payment date below.
ALL PAYMENTS MUST ONLY BE PAID INTO THE ACCOUNTS LISTED ABOVE AS EACH XTRA TIME SERVICE HAS ITS OWN SPECIFIED ACCOUNT. THIS HELPS US TO ALLOCATE YOUR PAYMENT. IF YOUR PAYING BY CHILDCARE VOUCHERS AND YOUR PROVIDER IS NOT LISTED ABOVE PLEASE CONTACT US.

When making a payment, please use the following reference: Sarratt - Child's Name.
Payment Reference:*
Payment Date:*

DayMonth Year
Date
CHILDCARE VOUCHER PAYMENTS MUST BE PAID IN FULL ON THE DATE YOUR BOOKING FORM IS SUBMITTED. THE EXACT PAYMENT AMOUNT ON YOUR BOOKING FORM MUST BE MADE IN FULL, USING THE REFERENCE BELOW. IF THIS PROCESS IS NOT FOLLOWED YOU WILL NOT HAVE SECURED YOUR CHILD'S BOOKING, AND YOUR CHILD WILL NOT BE ABLE TO ATTEND THE CLUB.
Additional Comments:
Any additional information that will help us understand your child's needs better
Do you give consent to Xtra Time Kidz Club to take pictures or videos of your child which will ONLY be used for marketing purposes (Social media platforms, www.xtratime.co.uk, flyers and other advertising purposes)?*

YesNo
Do you follow us on social media?*

YesNo
Thank you for following us on social media.
Please Like, Share and Subscribe to our social media platforms by clicking on to the images below.
Did you know we do Birthday Parties?

Is your child's birthday within the next 3 months? We are offering an exclusive £25 off Birthday Party Bookings to all existing customers. Visit our Birthday Party Form by clicking here and a member of our team will be in touch with you.
Did you know we do Private One-to-One / Group Tuition?

Would you be interested in a variety of Private One-to-One / Group Tuition for you or your child? Focusing on upskilling, mental health, well being, weight loss, confidence and more. Visit our Private 1-to-1 / Group Tuition Booking Form by clicking here and a member of our team will be in touch with you.
How Did You Hear About Us?*

Email / Text / WhatsAppHoliday Camp FlyerMy Child's SchoolFamily / FriendsSearch EngineSocial MediaOther
Other: How Did You Hear About Us:*
Other way you heard about us:
Signature

Clear
* Please note: Duplicate bookings and payments being charged twice are solely down to the Booker clicking the submit button more than once, all fees incurred for processing a refund will be payable by the person who made the booking. To avoid any inconvenience, please be patient while your booking is being processed.
GDPR

YES
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EmailDirect MailCustomized Online Advertising
Date

DayMonth Year
Date
Should be Empty:

EpiPen.