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County Community Trust - Free Holiday Provision
Where: Dial Park Primary School
Half Moon Lane
Offerton
Stockport
SK2 5LB
When: Tuesday 3rd January - Friday 6th January
Time: 10.00am - 3.00pm
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* Indicates required question
Question 1
Child 1 full name:
*
Your answer
Child 2 full name:
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Your answer
Question 2
Child 1: Date of Birth
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MM
/
DD
/
YYYY
Child 2: Date of Birth
*
MM
/
DD
/
YYYY
Question 3:
Child 1 Child's Age:
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Your answer
Child 2 Child's Age:
*
Your answer
Question 4. Address:
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Your answer
Question 5. Postcode:
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Your answer
Question 6. Name of Parent & Contact number:
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Your answer
Which day would you like to attend.
(please note you can attend all days)
*
Monday
Tuesday
Wednesday
Thursday
Friday
Full week
Required
Question 7. Email Address: please ensure you type your email correctly to receive confirmation email.
*
Your answer
Question 8. Primary School:
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Your answer
Question 9. Eligibility Criteria: Please have a look at the questions below and tick appropriate box:
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Is your child in receipt of benefits related free school meals
Yes
No - If your answer is no please have a look at the next set of questions and tick appropriate box
Child living in area of high deprivation
Child with behavioral, emotional and social needs
Family is experiencing financial hardship due COVID - 19
Looked after child
Child with an EHC plan (education, health, and care)
Child assessed as being in need
Required
Question 10. Disability
Your answer
Do we need to know of any medical history
*
Yes
No
Other:
Required
If yes, please let me know below
*
Your answer
Question 11. Lunch Pack Information: Please note the lunch pack will include a piece of fruit, healthy snack bar, and bottle of water each day.
*
Ham
Cheese
Tuna
Question 12. Any dietary requirements:
Your answer
Question 14. Are you happy for County Community Trust to take pictures and film sessions, this content may be shared on our website or social media platforms
*
Yes
No
Disclaimer by booking onto any of the course at DIal Park Primary School you information will be shared with Stockport MBC and other partners. Please sign below:
*
Your answer
If you required anymore information or support on any of the questions above please don't hesitate contacting Community Trust
Email:
Communitytrust@stockportcounty.com
Contact number: 0161 266 2700 option 5
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