Xtra Time Ad Hoc Booking Form

Xtra Time Leavesden Green JMI School

Ad Hoc Booking Form (2025/2026)

Please complete the booking form below to secure your child's place for Xtra Time Breakfast and After School Clubs
Ad Hoc Bookings Policy

Ad Hoc bookings can only be made a week in advance for the desired sessions. For bookings needed further in advance, please use the term time booking form.
Parens/carers must call prior to booking to ensure we can accommodate their request. Spaces are offered on a first come, first served basis.
Ad Hoc bookings are subject to availability and are offered at the manager's discretion. To avoid disappointment, please contact Xtra Time to confirm availability before submitting a booking form. Bookings made without prior approval may be refused.

Contact Information for Enquiries

Please use the appropriate number based on the time of day:

9:00am to 2:30pm (Office Number): 07746 945 903
2:30pm to 6:00pm (After School Club Provision Manager): 07380 935 279

Advance Booking Recommendation

We will always try to accommodate your childcare needs. However, we strongly encourage all parents/carers to book the half term in advance to secure your child's space and avoid disappointment. This allows us to plan and prepare for your child's attendance in advance.
Have you completed a registration form?*

Yes - I have completed an annual online registration formNo - Please complete an annual online registration form first
Xtra Time Registration Requirements

Xtra Time do not charge a registration fee for children that attend less than three sessions in an academy year. This is to support parents who need one off childcare without having to pay a registration fee in addition to an Ad Hoc booking fee for a one off booking.

T&Cs do apply: All parents/carers must complete a Registration Form before their child can attend. Whether your child attends one session or is regular booker, every child must have a completed Registration Form along with their Ad Hoc booking before their child can attend our club.

Once your child has attended three sessions (AM or PM) parents/carers will need to pay their Registration Fee. Most parents/carers are regular bookers and know their child will attend more than three sessions in an academic year (September 2025 to July 2026) and therfore pay their registration fee on submission.

Click here to complete your Registration Form.

*Please note: Bookings submitted without a completed Registration Form submission will not be accepted.
Which setting would you like to book onto?*
Child's Full Name*

First NameLast Name
Child's School*
Child's Year:*
Child's Class:*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian E-mail*
example@example.com
Emergency Contact 1*
Mobile number
Emergency Contact 2*
Medical Conditions?*
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 child 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?*
Details of Medical Condition(s) / SEN:*
The costs for the sessions are as follows:

Breakfast session: £9.00 (this session runs from 7:30am to the start of school)

After School session: £18.50 (this session runs from the end of school to 6pm)
Ad hoc booking 1
Please note: You must select a date before selecting the session(s) below.
Booking 1 - Date of attendance

DayMonthYear
Booking 1 - Please select the club you require

Wake Up / Shake Up Breakfast ClubExtended After School Club
Booking 1 Total £
Ad hoc booking 2
Please note: You must select a date before selecting the session(s) below.
Booking 2 - Date of attendance

DayMonthYear
Booking 2 - Please select the club you require

Wake Up / Shake Up Breakfast ClubExtended After School Club
Booking 2 Total £
Ad hoc booking 3
Please note: You must select a date before selecting the session(s) below.
Booking 3 - Date of attendance

DayMonthYear
Booking 3 - Please select the club you require

Wake Up / Shake Up Breakfast ClubExtended After School Club
Booking 3 Total £
Ad hoc booking 4
Please note: You must select a date before selecting the session(s) below.
Booking 4 - Date of attendance

DayMonthYear
Booking 4 - Please select the club you require

Wake Up / Shake Up Breakfast ClubExtended After School Club
Booking 4 Total £
Grand Total for sessions:
Payment Method:*

Bank Transfer - Please follow the instructions belowChild Care Vouchers - Please select your provider below
Childcare Voucher Provider:*

CO OP - 85116843EDEN RED - P20733006KIDDIVOUCHERS - EY444153CARE4 - 18475662BUSYBEES - Xtra Time Kidz ClubCOMPUTERSHARE - 0020197568RG CHILDCARE - 97926708410FIDELITI - XTR001CFAIRCARE - XTHO0218SODEXO - 850954OTHER - Provide details in additional comments box
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 XTLeavesden - Child's Name. 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.
Please make your booking payment in full to the account below:

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 below, 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.
Payment Reference:*
Payment Date:*

DayMonthYear
Date
Please attach a screenshot of your payment below.*

If you are unable to attach a screenshot of your payment, please write the details of your payment on a piece of paper stating the reference, date and amount paid. Providing this enables our finance team to easily find your payment and avoid the need to contact you. Please do not contact us to confirm if your payment has been made. We will contact you if there are any issues with your payment. Your submission of this form and confirmation email is confirmation of your booking.
Cancelof
Please continue with your Ad hoc form as you normally would. Once you get to the additional comments section please write that you have made a bank transfer, including your child's name, reference used, payment amount and payment date. We are working very hard towards fixing this issue. We apologise for any inconvenience.
Please Note: You will not get a confirmation message from Xtra Time Kidz Club when you have processed your payment. If there are any issues with the payment, a member of our finance team will get in contact.
Additional comments:
We are offering an exclusive £25 off Birthday Party Bookings to all existing customers, would you like the Xtra Time team to help plan your child's next birthday party? *

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.
By selecting the check box below, you agree to our T&Cs.
I consent to Xtra Time Kidz Club/1st Touch Coaching taking pictures of my child which may be used for marketing purposes (Social media platforms, website, flyers and other advertising purposes only). *

YesNo
I have completed this booking form as honestly and accurately as possible, I understand that Xtra Time Kidz Club/1st Touch Coaching can only provide the best service based upon the information I provide. If my child has any special requirements, for example toileting or SEN. I have added this information in the additional comments section above*

By selecting this box I accept the above
Please sign below to confirm the sessions listed above are the sessions you would like your child to attend.*

By selecting this box and signing below I agree my booking is correct.
Signature:

Clear
Once the submit button has been clicked your booking is being processed, please do not click the submit button more than once otherwise you will create a duplicate booking and get charged twice. 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.*

By selecting this box I accept the above
Date

DayMonthYear
Date
Should be Empty:

EpiPen

Ad hoc booking 1

Ad hoc booking 2

Ad hoc booking 3

Ad hoc booking 4