Parkgate Infants & Nursery Wednesday Football Frenzy Booking Form (Autumn Term

Dear Parent/Guardian,

Please complete the booking form below to secure your child’s place at the Xtra Time After School Sports Club. By completing this form, you acknowledge that Xtra Time is an external provider. All enquiries, including those regarding bookings, registrations, payments, changes, and feedback must be directed to Xtra Time and NOT the school office.

Please ensure your child arrives with clean, unlaced footwear. This preparation will allow children to get ready for their activities much more efficiently.

If you have any questions, please emaial: sportscoach@xtratime.co.uk

Finish Time:

Every Wednesday from 23rd Sept - 9th Dec (11 weeks) = 66.00

(This session runs from 3.10pm - 4.10pm)

Open to boys & girls in Reception, Year 1 to Year 2

ONLY 32 SPACES AVAILABLE

Prizes, trophies, medals, and certificates to be won

Please note: Our coaches will always aim to arrive at the school 15 minutes before session starts, our session are delivered on the school site. Registers are emailed to the school office which are then passed on to your child's teachers.

Child's Full Name:

First NameLast Name

Child's School:

Child's Year:

Child's Class:

Medical Condition(s):

Our First Aid Trainers have advised that a second dose of an EpiPen should be administered 5-15 minutes after the initial dose if there is no improvement in the child's condition. This protocol ensures critical support while awaiting the arrival of emergency services. Consequently, if your child requires an EpiPen, they must have two devices with them at all times. By confirming this requirement, you acknowledge that your child will attend each session with two EpiPens. Please be advised that if a child does not have two EpiPens available, they will be sent to the school office and will be unable to attend the Xtra Time Kidz Club session. This policy is in place to safeguard both your child and our staff. Thank you for your cooperation in this matter. It has been advised by our First Aid Trainers 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 EpiPens. This is to safeguard your child and Xtra Time Kidz Club Staff.

Does Your Child Have Any SEN:

Does your child have any SEN (Special Educational Needs)?

Details of Medical Condition(s) / SEN:

Please provide details of any medical conditions.and/or Special Additional Needs. For example:Asthma and/or ASD etc

Parent/Guardian Name:

First NameLast Name

Parent/Guardian E-mail:

It the parents/carers responsibility to ensure they have input their email address correctly to ensure they receive important club updates such as cancellations due to Amber/Red Weather warnings.

Emergency Contact 1:

Mobile number

Emergency Contact 2:

Mobile number

Full Address:

Street Address

Street Address Line 2

CityCounty

Postcode

Collected By:

Name of person collecting your child

Relationship To Child:

What is their relationship to your child

Security Code:

Choose a security code of your choice that'll be used if somebody else collects your child

Sub Total £

Grand Total:

Payment Method:

Please make your booking payment in full to the specified account below:

1st Touch Coaching Ltd (T/A) Xtra Time Sports Services

Account Number: 33376844

Sort Code: 09-01-29

Payment must be be made in full to secure you booking

Payment Reference:

Please use your child's school name and your child's full name as your payment reference. For example: 'Parkgate Infant Alan Smith'

Payment Date:

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 paper stating: Your payment date, amount and reference. Providing this information will help us locate your payment and avoid the need for us to contact you,

Additional Comments:

Any additional information that will help us understand your child's needs better

Do you give consent to Xtra Time Kidz Club to take pictures or videos of your child which will ONLY be used for marketing purposes (Social media platforms, www.xtratime.co.uk, flyers and other advertising purposes)?

Do you follow us on social media?

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.

Community Give Back

If you are in need of further support, please fill out our enquiry form here and a member of our team will be in contact with you to see how we can assist. All throughout the year, Xtra Time strives to help as many families in the local community as possible, and in particular we have a big push for the Christmas period. In the past we have helped over 300 families by providing food, amenities and toiletries and every year, we want to be able to provide even further support.

Birthday Parties & Inflatables

Take the stress out of party arrangements and let Xtra Time organise your child's birthday party for you. Whether it you want a football theme, prince party or an inflatables fun fest, we got you covered! Visit our Birthday Party booking form here for more about what we can offer you.

Private One To One & Group Tuition

Are you ready to take the first step in creating the best version of your child? We offer a variety of private one to one programmes which can be tailored to individuals or group of children or adults. We offer upskilling, mental health, well being, weight loss, confidence, advanced programmes and so much more. For more information click here and a member of our team will read out to create a bispoke promgramme tailored to your needs.

How Did You Hear About Us?

Other: How Did You Hear About Us:

Other way you heard about us:

If the weather is inclement, coaches will move activities indoors (subject to available space), Children will either participate in indoor sports or a sports related quiz in a classroom setting. To compensate for any lost playing time, in the following week's session we will prioritise matches over skill work. While indoor sessions are a rare occurrence, we encourage parents to send their child in with weather appropriate clothing. We aim to conduct sessions outdoors whenever possible to ensure the children receive the maximum benefit from our clubs.

Bookings for After School Clubs are non refundable. Our clubs are delivered based on confirmed numbers before the club begins. We then commit to paying all associated overheads, including facility hire, insurance and staffing for the full term in advance to ensure the club's viability. If you would like to schedule a trial session before committing to the full term, please email: admin@xtratime.co.uk. Please note: A single trial session is £10. When you proceed with your full term booking you trial session will be deducted from the outstanding balance.

To keep up to date with important news, alerts and updates. please save the office contact number to your contacts as part of completing your booking form. 07746 945 903.

It is the parents/carers responsibility to ensure they have input their email address and emergency contact details correctly to ensure they receive important club updates such as cancellations due to Amber/Red Weather warnings.

Please note the start and end dates for this club, which are located at the top of the booking form. This section also includes any dates when the club will not be in session, such as bank holidays, parents' evenings, or inset days.

Please sign below to confirm your booking.

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