Application Form

Little Raindrops Application Form
Child's Full Name
Birth Date

DayMonthYear
Mothers Name
Fathers Name
Names and ages of Brothers and Sisters
Address
Telephone Number
Mobile Number
E-mail
Does your child have any identified additional needs
Does your child have any allergies
Does your child have any intolerances
Is your child on any ongoing medication
First/Home Language
When would you like your child to start with us
Sessions

Please tick your preferred days and sessions
Breakfast Club from 8am £6 or from 8.30am £3

MondayTuesdayWednesdayThursdayFriday
Morning Session 9am-12noon £18

MondayTuesdayWednesdayThursdayFriday
Lunch Club 12-12.30pm £3.00

MondayTuesdayWednesdayThursdayFriday
Afternoon Session 12.30-3.30pm £18.00

MondayTuesdayWednesdayThursdayFriday
After School Club until 4.30pm £6 or until 6pm £16

MondayTuesdayWednesdayThursdayFriday
Any Additional Information. If selected Breakfast Club or Afterschool Club please indicate the time you would like, either 8am, 8.30am or 4.30pm, 6pm,
Should be Empty:

Little Raindrops Application Form