Summer Camp Detailed Registration Form

STEM Explorers

Holiday Club
If your child receives benefit related Free School Meals please apply via this link. This programme is free for eligible children.
Child Information
Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Gender
What is your child's school?
Select your Child's Year Group
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Format: 00000000000.
Mobile Number
Format: 00000000000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Their Phone Number
Format: 00000000000.
Alt. Phone Number
Format: 00000000000.
About your child
Does the child have any allergies, chronic illness, or medical conditions?
If yes, please explain in detail.
Does your child have a health care protocol in place at school?
If this child has a medical condition, is this likely to cause difficulties in participating?
Does your child have any identified Special Educational Needs or Disabilities (SEND)?
Does your child have an Education, Health and Care Plan (EHCP)?
Please give details if you answer yes to any of the above.
Is there any other information that may be useful to us about your child?
Our Easter Holiday programme include Food provision. Children will be offered, snacks, drinks and lunch.
Food Provision
Please Select any dietary requirements
If you select Other please specify.
Our Holiday club is a conitnuing programme. Selecting all sessions will give your child the bext experience.
Select the sessions
Confirmation

Once we receive your completed registration, we will issue an invoice for payment. A place is only secure once the full payment is paid. Please note that all fees must be paid in advance of the class start date and are non-refundable in the event of absence. Please also note that, this experience consists of a leisure activity, on a specific date(s), and therefore the 14-day ‘cooling off period’ under the Consumer Contracts Regulations 2013 does not apply.
Date

MonthDayYear
Date
Signature
Should be Empty:

STEM Explorers

Child Information

About your child

Our Easter Holiday programme include Food provision. Children will be offered, snacks, drinks and lunch.