24/25 Registration form

Shout Out! registration form '24/25

Please complete this form for your child(ren) to join us at after school club during the 24/25 academic year
Child 1*

NameAge
Child 2

NameAge
Parents Details

First NameLast Name
Email*
example@example.com
Phone number*
Please enter the best number to contact you on in case of an emergency
Address*

Door number

Street Address

City

Postcode
Which days do you wish to book?

Monday - Club CreateTuesday - Drama Club 5-10 year old's (until 5.30pm)Thursday -Club CreateFriday - Performing Arts Club
Breakfast club booking

MondayTuesdayWednesdayThursdayFridayBrunel Field PrimaryAshley Down Primary
Wednesday craft club is now Fully booked. Please tick here if you wish to be added to the waiting list

Yes, add my child to the waiting list
Do you require school pick up?*

Yes- from Sefton ParkYes - from Brunel FieldNo - my child will be dropped to the venue for 4pm
Child's class name & year group*
type N/A if pick up not required
Clear directions to classroom /pick up location*
type N/A if pick up not required
Any medical / allergy information? please also include any medication your child needs during their time with us and any instructions for use
I will notify Shout Out! via Email (or text if the same day) if my child has not attended school / or does not need picking for any reason.*

I agree
Do you consent to photos/videos being taken of your child for documenting the classes or promotional material?*

YesNo
Please choose an option for payment. Online payments will incur a £1.50 fee.
prevnext( X )
1st child - 8 week term Please select this option to book your child in for 1 of the classes. £1.50 booking fee incl.
£109.50 Quantity



Deposit to hold space PER CHILD PER CLUBPlease select this option if you wish to pay closer to the time but wish to reserve your child's place. Deposits are £35 per child and are non refundable. the £35 will be deducted from the remainder of your term fees. £1.50 booking fee incl
£36.50 Quantity



Sibling (2nd + child) - 8 week term Please select this option to book your 2nd+ child in for 1 of the classes. Please change the quantity based on how many days your child will be attending. £1.50 booking fee incl
£101.50 Quantity



child- no pick up - 8 weeks Please select this option to book your 1st child in but you DO NOT require pick up & food. Please change the quantity based on how many days your child will be attending. £1.50 booking fee incl
£89.50 Quantity



Paying via bank transfer Please click this option if you will be paying via your childcare account or bank transfer
£ Free



Total

£0.00
I understand that the sessions are booked in termly blocks and my child's place will need to be renewed each term. If you join Shout Out! later in the term, you will pay separately for the remainder of the term.*

I understand
Pay with PayPal

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
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Shout Out! registration form '24/25