Breakfast or After-school Club
Please fill out ONE form per child
Expression of Interest
Please answer each question in full
1. I am interested in
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Breakfast club (only for St Matthew’s Primary School) **We would take your child/ren to school.
The after-school club
Both
2. What time would you prefer if you are interested in the breakfast club?
7:45-8:45 (with breakfast)
8:00-8:45 (drink and play)
3. What time would you prefer if you are interested in the after-school club?
3:15pm-4:15pm
3:15pm-4:45pm
4:15pm-5:30pm
3:15pm-5:30pm (with tea/ dinner)
4. How many days would you require this service?
*
Up to 5 days - Monday to Fridays only
5. Name of your child
First Name
Last Name
6. Name of School your child attends
*
7. Year Group in School
*
8. Child date of Birth
*
-
Month
-
Day
Year
Date
9. Does your child have any health issues?
10. Any allergies (please list)
11. Name of parent/guardian and telephone contact
*
Parent first and last name
Telephone number
11. Parent/Guardian email address
*
example@example.com
What would be the best date/time to call you?
*
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Data Protection
Upon receipt of your registration form MADE will be the Data Controller of your personal data. MADE will hold all the information you havegiven on this form for legal requirements and for the purposes ofadministration and statistical analysis. Your information will be held on a manual file and will also be enteredin its current or altered format onto the company’s computerised database. No information will be passed onto a third party.
SUBMIT APPLICATION
Should be Empty: