After school creative club St Lawrence School Hurstpierpoint After School Club - St Lawrence School Parents Name Email Address Home Address Contact Number Emergency contact number (if different from above) Name and DOB of Child Attending Name and DOB of Child Attending Name and DOB of Child Attending What Year is your child in? Class Name Year 1/Year 2 Class Location Year 1/Year 2 Class Location Pirate ShipMiddle Pickett Fence RH doorMiddle Pickett Fence LH doorFar Corner PickettClass closet to bottom exit Session You Are Booking Session You Are BookingOne Off SessionFull Term What day(s) would you like to visit? Would you like pick up from school or will you be dropping off? Would you like pick up from school or will you be dropping off?Pick up From St. LawrenceDropping off @poponin What time does your childs school day end? Time you will pickup your child Time you will pickup your child4.30pm5.00pm5.30pm6.00pm Who will be collecting your child? Doctors Name and Address Please advise if your child has any allergies. Please advise if your child has any allergies. No Yes If you answered Yes to the above please provide details. Do you know if your child has had a reaction to 'arts and craft' materials ie paints, glue, glitter etc. Do you know if your child has had a reaction to 'arts and craft' materials ie paints, glue, glitter etc. No Yes Is your child allowed a snack and drink whilst at poponin? Is your child allowed a snack and drink whilst at poponin? Yes No Payment Terms Payment TermsOne Off Booking (daily rates)Full Term In Advance (attracts reduced rate)Full Term Split MonthlyFull School Year In advance (full school year, attracts reduced rate plus 3% discount) Costs Costs£16.00 up to 5.00pm/£17.50 up to 5.30pm/£21.00 up to 6.00pm (daily rates)£15.75 up to 5.00pm/£16.50 up to 5.30pm/£20.00 up to 6.00pm (monthly payment scheme))£14.75 up to 5.00pm/£16.00 up to 5.30pm/£19.50 up to 6.00pm (full term in advance) poponin take photos/video for promotional purposes. Are you OK with your child being in photos/video? poponin take photos/video for promotional purposes. Are you OK with your child being in photos/video? Yes No Would you like to receive the poponin newsletter? Would you like to receive the poponin newsletter? Yes Already receiving No Please use this space for any other information you think useful or helpful to the poponin team. Thank You. Please Confirm Please Confirm I confirm I have read the Terms and Conditions* 4 + 2 = Submit Thank You. Confirmation will be sent on receipt of your form.