Christmas Holiday Club - Educating Kids Outdoors

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Christmas Holiday Club

Christmas Holiday Club

Tuesday 2nd to Friday 5th January 2024

Please note that this club is for children in Years 1 to 8 ONLY
Child's Name*
First Name Surname / Family Name
My child attends the following school*
Please enter the name of your child's school
School Year*
Please select the CURRENT School Year your child is in
Name of Parent/ Guardian*
First Name Surname / Family Name
Email*
Please provide the email address that you would like ALL correspondence to go to.
Mobile*
Please provide one mobile phone number that you can be contacted on in the event of an emergency during the Holiday Club.
Does your child have any medical conditions that we should be aware of?*
No
Asthma or Bronchitis
Severe Allergies requiring an EPI pen
Other Allergies
Other
Does your child have any dietary needs that we should be aware of?*
No
Vegetarian
Vegan
Other
Does your child have any SEND needs that we should be aware of?*
No
Dyslexia
ADHD / ADD
Autism
SEND with 1 - 1 support in school
Other
Please contact us if your child receives 1:1 support in school before completing the booking form.
Please give more details of your child's medical, dietary or SEND needs as necessary
In the event of a minor accident and when I cannot be contacted, I agree for First Aid to be administered by a qualified First Aider.*
Yes
No
My child is eligible for benefits related Free School Meals and qualifies for a HAF funded place*
No
Yes
If you answered yes to the previous question please type in your HAF code
Please check your Council's website for how to get a HAF code if you have not received one from your school. Failure to use the correct code may result in you being charged for your child's place.
I give my consent for photographs and or film of my child to be used for EKO Ltd. displays incl. internet site and social media*
Yes
No
I give my consent for photographs and or film of my child to be used for STAFFORDSHIRE / SHROPSHIRE / TELFORD & WREKIN COUNCIL displays incl. internet site and social media*
Yes
No
"Please be aware that photographs / video taken at HAF events, holiday clubs and activities are for promotional purposes and may be used by Staffordshire / Shropshire / Telford & Wrekin County Council"
I wish to be kept informed of other EKO Ltd. activities and events.*
Yes
No
As the parent/guardian I have read, fully understand and am satisfied with the details supplied regarding EKO Ltd. Club activities and agree for my child to take part in them.*
Ticking 'Signed' means you have electronically signed for this.
Signed
Christmas Holiday Dates 2022
Please select the date followed by the appropriate payment option. Please check your HAF eligibility before making a HAF booking.
Tuesday 2nd January
Wednesday 3rd January
Thursday 4th January
Friday 5th January
I wish to pay for my child's place using CHILDCARE VOUCHERS*
No
Yes
If you answered yes to the previous question please enter the name of your childcare voucher provider
PayPal Payment Total
VOUCHER PAYMENTS ONLY. Please note that this form cannot calculate the total voucher payment to be paid. We will send you conformation of the total to pay for your booking shortly.
Billing Information
Please enter your billing information
First Name*
Last Name*
Email*

Please provide the email address that you would like ALL correspondence to go to.
Address*
Address 2
Town/City*
County*
Postcode*
Country*
Holiday Club Payment
£ 0.00
If you have chosen to pay by CHILDCARE VOUCHERS we will send you confirmation of the payment required shortly.

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Do get in touch today with any enquiries or questions you may have, we are always happy to talk.

Call: 07876658467
Email: info@ekolearning.org.uk

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Educating Kids Outdoors Ltd

Registered charity in England and Wales (1191685)

A company limited by guarantee, registered in England and Wales company number 12114074.

Registered office: Astol Farmhouse, Norton, Shifnal, Shropshire TF11 9EW

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