SEPTEMBER HOLIDAY PROGRAMME ENROLMENT FORM

Placement in the Holiday Programme is not registered until a complete Enrolment

Form, including payment is received.
Please circle times and days that your child will be attending. If you intend to
collect your child after 3.00pm they need to be enrolled for the period 3.00pm CHILD DETAILS
– 6.00pm.
Surname: _______________________ First Name: ________________________

8+ YEAR OLDS Address: ___________________________________________________________

WEEK 1 __________________________________________________________________
TIME MON TUE WED THU FRI Allergies / Medical Problems / Cultural requirements:
27 28 29 30 1 __________________________________________________________________

8–3 $25.00 $25.00 $25.00 $25.00 $25.00 Age of Child: ______

CONTACT DETAILS OF PARENTS/CAREGIVERS

3–6 $10.00 $10.00 $10.00 $10.00 $10.00
Name: _____________________________________________________________

TOTAL Phone: _______________ Mobile:___________________ Work :______________

At times photos of your child/ren completing activities maybe taken to display on the
WEEK 2 notice board/OSCN training newsletter. Are you happy to allow this?
TIME MON TUE WED THU FRI
4 5 6 7 8 YES NO

8–3 $25.00 $25.00 $25.00 $25.00 $25.00

I give permission for my child to leave the school grounds for planned trips.

3–6 $10.00 $10.00 $10.00 $10.00 $10.00 YES NO

I give my consent for my child to attend the School Holiday Programme on the days
TOTAL as requested. I agree to inform the programme co-ordinator prior to my child
attending if I feel they may need special attention (e.g tends to wander). I
understand that all programme staff will exercise due care but will not be liable for
any injury, damage or loss, which my child may sustain to person or property.
• Trips are subject to weather conditions, and may change accordingly.

• Refunds will not be given for cancelling within 1 week of booked day,
unless for medical reasons. (Doctors certificate will be required for Signed: _____________________________________ Date: ________________
refund).