Sparkles Registration Form
Sparkles Club runs daily during term time from 3.30pm to 5.30pm. The fee for a child to attend is £3.00 per hour or £5.00 for full session. This must be paid on the day or in advance. Children must be booked in in advance.

Please complete form to register your interest - We will then confirm when your child can start
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Child's Full Name *
Child's Date of Birth *
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Class and Teacher's Name *
Please tick the days you would like your child to attend Sparkles Club: *
Required
Parent/ Carer Contact Information - Home Address *
Parent/ Carer’s Name *
Relationship to child *
Contact Number *
Emergency Contact Details – In case of an emergency we will contact the parent/carer above. If unavailable, please list two further contacts that you would be happy to act on your behalf                                              Emergency contact Number 1 (State relationship to child): *
Emergency Contact Number 2 (State relationship to child) *
Does your child have any food allergies? (If yes, please detail, if not state 'No') *
Does your child have any specific dietary needs/ food intolerances or allergies that we should be aware of? (If yes, please detail, if not state 'No') *
Do you observe any cultural or religious procedures that you feel we should be aware of? (If yes, please detail, if not state 'No') *
I give permission for photographs to be taken of my child enjoying their time at breakfast club. They may be used in wall displays. *
I give permission for photographs to be taken of my child enjoying their time at breakfast club. They may be used on the school  Breakfast Club web page and school website                                                                                     No names will be put alongside photos *
By signing this form you confirm that you have read, understood and agree to the terms outlined in this application form and to the School’s Breakfast Club policy (Please type name) *
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