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St Peter and St Paul Catholic Primary Academy

Stars Form

Surname* Forename* Date of birth* Year Group* Address* Home Telephone* Home Email*

Emergency Contact information:

Contact 1

Name/Relationship* Telephone*

Contact 2

Name/Relationship* Telephone* Medical Conditions

During your child's time at “Stars” there may be occasions where we will require parental consent. To enable us to act efficiently without contacting you on each occasion, we would appreciate your written consent as below:

I give/do not give permission for my child to be photographed.*I DoI Do Not

Food Activities/Cooking
One of the activities we offer will be cooking or food related activities. Please indicate below if your child has an allergy to a particular food.

My child should not eat or touch the following foods:*

Plasters
Health and Safety regulations now state that we must have your permission to apply a plaster to a cut or graze in case a child is allergic to them.

My child *is/is not allergic to plasters* I *would/would not like one applied to a cut or graze* Please tick which sessions your child will be attending.*

Terms and Conditions
1. A registration form must be completed before your child will be allowed to stay in the “Stars” Extended Hours provision.
2. Fees must be paid in advance, no less than one full week, by Parentmail2 or cheque. £4 for Morning Stars (breakfast included), £11 for Afternoon Stars (tea included), £5 for Afternoon Stars collected by 4.30pm (tea not included). Any child attending 5 morning and 5 afternoon sessions in a week will be charged at the reduced rate of £70 per week. A 10% discount for siblings will apply.
3. Fees are to be paid irrespective of illness, holidays or any other reason (except school closures and INSET days)
4. If a child is not collected by 5.45pm, late fees will apply at the rate of £10 per quarter hour.
5. From the start of the second half of the Autumn Term until the end of the Spring term, parents may drive through the school gates to drop off and collect their children from “Stars”. This will only be during the hours of 7.25am and 7.45am and then again between 3.30pm and 6pm whilst it is dark. Please use the intercom buzzer to gain access.
6. The School Governing Body reserves the right to withdraw any child if their account is not paid when due.
7. Two weeks written notice to reduce the number of sessions your child attends is required.
8. Children are expected to show good behaviour to staff and other children.

I confirm that I have read and understood the conditions above and understand that should my account fall into arrears, my child will not be able to attend and I will have to make alternative childcare arrangements.*Yes

We understand that there may be occasions when problems with travel result in you having to make alternative arrangements for your child to be collected. Please give the name of any person that you may use in this instance together with a password that only you and they would know.

Name* Known as (by your child)* Password*

Please type the letters and numbers displayed in the image into the textbox below to verify you wish to send this response. If you have difficulties reading the letters in the image below you can try a different image by clicking on it.

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Afternoon Stars
Breakfast Stars