Summer 2023 Holiday Fun Program

Summer Holiday Fun Program

We will be offering limited free spots and payed spots of £15.00 per day. To be entitled to a free spot, you must fit the following criteria, your children must either live or go to school in Westminster and be on benefit related free school meals. Filling in this form does not guarantee you a place at the program but it highlights your interest and we will Place you on a waiting list. we will be in touch with you within 3 working days.
Childs Information
Childs Name

First NameLast Name
Birth of Date

MonthDayYear
Gender

MaleFemale
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Details
Name of School
School type:

PrimarySecondary
Class: e.g Year 5
Borough of their school e.g Westminster
Is the child considered to be Refugee or Asylum Seeker ?

YesNo
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Phone Number

Area CodePhone Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Does the Child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Does your child require any reasonable adjustments? If yes please specify
Does your child receive income based free school meals:

YesNo
Does your children have any food requirements (All food provided will be Halal) ?

Dairy free and lactose freeVeganVegitarianOther
If other please let us know what special food requirements your child would require:
Please chose the dates your child will attend :

You can pick between 1-16 days, and we will be in touch to confirm the firmed spaces as they will be given on a first come first serve bases. We aim to have one trip a week and they will be added shortly.
Week 1 : please chose the dates your child will attend :

Type option 1Type option 2Type option 3Type option 4
Week 2 : Please chose the dates your child will attend :

Sunday 30th July 1Monday 31st JulyTuesday 1st AugustWednesday 2nd August - Trip on the Floating Classroom (Boat Trip)
Week 3 : Please chose the dates your child will attend :

Sunday 6th AugustMonday 7th AugustTuesday 8th August - Trip to the Science Museum, LondonWednesday 9h August
Week 4: Please chose the dates your child will attend :

Sunday 13th AugustMonday 14th AugustTuesday 15th AugustWednesday 16th August
How did you hear about our Summer Program ?
Should be Empty:

Summer Holiday Fun Program

School Details

Please chose the dates your child will attend :