Waiting list Easter Holiday Club 'Xpress      
4-11 year olds in Primary School  11am-3pm         
9th-12th April (Tuesday-Friday) 

Please fill out the form below if you would like to add your childs name to the waiting list to attend Holiday Club. 
We will let you know on Tuesday the 9th April before 6pm if any places have become available due to childrens non attendence for Wednesday10th, Thursday 11th and Friday 12th.


General information
Holiday clubs include: Games, Sports, Creativity, learning, bouncy castle, play, friendship and lots of fun!!

Cost: £3 a day for all children which includes a healthy lunch or £10 for a week. (Children can bring their own)

Free for children on means tested free school meals (this means you have registered for free school meals due to receiving benefits)

Ensure you read our child care policy before completing the form.

We will offer children a mix of healthy foods
Fruit, Vegetables, Sandwiches, Wraps, Pasta, Pizza, Meat (halal), Tuna, Cheese, Popcorn and Water

If you have an older child in secondary school who would like to help as a young leader please advise our youth manager, Salome on salome@westbourneparkfamilycentre.org.uk.  


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Email *
Which days would you like your child to attend? *
Required
Has Your child attended any of the following sessions since September last year? *
Required
Legal First Name of Child *
Legal Surname *
Gender *
Date of Birth (DD/MM/YYYY) *
MM
/
DD
/
YYYY
Please advise the ethnicity of your child *
Post Code *
School Attending *
School Year *
Required
How did you hear about the holiday club *
Required
Which Ward do you live in? *
Required
Parents Mobile *
Name and contact details of parent/carer and one other person we can contact in case of emergency.  The named persons can also collect the child *
 Doctors name and telephone number *
Does your child have any medical complaints/allergies/special needs? If yes please specify.
Does your child have any additional/special needs? If yes, please provide as much detail as possible and if available an Education, health care plan. We will then contact you to discuss how we can best support your child.
Dies your child have a faith background? *
Free School Meals *
Yes
No
Does your child receive Free School Meals
Have you applied for Means test Free School Meals
Supporting your child *
Yes
No
Does your child speak English as an additional language (EAL registered)?
Does your childe have Special Educational needs (SEN registered)?
Does your child have a Education Health Care Plan
Does your child have a disability
I will allow my child/children to participate in any photographs which may be circulated in promotional advertising, local newspapers or childcare magazines.
Payment: £3 per day or £10 per week for children who have not been means tested for free school meals. 
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Once you have read our terms and condition at the bottom of the page please type your name below to confirm. *
The child/youth care policy is an agreement between the parent/carer and the staff of WPFC. If any of the following areas were to be breached, then it may result in the exclusion of the child. Holiday Club Xpress has 70 places available per week. 
Registration is 11.00am each day and collection at 3.00pm. If parent/carers fails to collect their child/youth within 15 minutes without good reason then the child may not be able to attend on the next occasion.
Personal Possessions: WPFC will not be held responsible for the loss of personal items or money. 
Safeguarding Guidelines: Under the children’s act, staff are obliged to inform social services of any concern regarding a child. If there are any issues surrounding a member of staff the parent/carer are advised to inform the leader in charge, Geoff Biggs. If concerns related to the leader in charge, Westminster Safeguarding Unit should be notified on Tel: 0207 741 5909.
Hygiene and health: Staff will not be held responsible for administering children’s medicine. If a child has an inhaler, then they will be allowed to treat themselves under staff supervision. If there are any concerns about a child’s state of hygiene of health, then parent/carers will be informed.
By signing this form, you will also be giving permission for staff to seek emergency medical treatment or advice for your child if necessary.  
Children’s behaviour: WPFC works hard to ensure that the children in care remain safe and comfortable. Therefore, if a child’s behaviour becomes unacceptable the parent/care will be contacted to collect their child. Parent/Carer Conduct: All parent/carers are requested to respect the environment of WPFC. If they are abusive to staff, shout or apply any form of physical force against a child or member of staff, then appropriate actions will be taken. 
GDPR:  GEoff Biggs is the Data Controller. The general Data Protection Regulation effects the way in which charities keep information. We will be sharing data with The Royal Borough of Kensington & Chelsea OR Westminster City Council and the Department for Education (DfE), as part of the monitoring requirements for this programme. This information will include your child’s full name, date of birth, school, gender, home postcode, and FSM eligibility. This information will be matched with school census information to monitor eligibility and reach of the HAF Programme. For more information on how we use your data, please refer to our privacy notice: Children's Services | Westminster City CouncilPlease see our privacy statement which explains what information we hold about adults and children who have registered with us. It also explains why we hold it, how we protect it, and how you can have information removed from our files. This can be found on our website at www.westbourneparkfamilycentre.org.uk. *I have read and agree with the above Child Care Policy
 *
A copy of your responses will be emailed to the address you provided.
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