St Monica's Catholic Primary School         Breakfast Club application form
Breakfast club is open from 8am.  The cost is £2 per day, per child.

PLEASE NOTE:      You will be charged for the days you select, even if your child does not attend. 

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Child's Name *
Child's Class
 *
I would like my child to attend breakfast on the following days.
Please note that you will be charged for the days you have selected, even if your child does not attend for any reason.
Please select the days that apply
 *
Relationship to to the child
 *
By completing this form, I agree to comply with the requirements of the breakfast club.

- I consent to any emergency medical treatment which is deemed necessary for my child during Breakfast club.
- I will notify the Senior Breakfast club staff of any changes to the information given.
- I understand that my child's place may be withdrawn, if I do not follow the agreed procedures.
Parent/Carer Name
 *
Parent/Carer Contact Number
 *
Today's Date *
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