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The check list below is to help you when booking your child/ren onto one of our playschemes.

You need to have the following information ready when you call us.

Please note, there will be additional questions asked during the telephone booking process.

If you have previously booked with us you will be asked to re-confirm information.

1.

What scheme do you wish your child/ren to attend? (see previous page)

4.

Child’s GP name, surgery, telephone number, medication, allergies, dietary or religious requirements:

3.

Which dates would you like to book? (full days only):

5.

If your child/ren has any additional needs or requires additional support please inform us at the time of

booking. We would be grateful for as much information as possible and we may need to send you

an additional information form with your booking confirmation, or speak to you on the phone.

The earlier you book, the more likely it is we can secure additional support for your child/ren.

6.

The names and telephone numbers of two emergency contacts (other than you):

Name

Telephone No 1

Telephone No 2

Name

Telephone No 1

Telephone No 2

2.

Child’s personal details: name, age, date of birth, address, along with:

Name of parent/guardian:

Contact number:

Referral Scheme number (if applicable)

*

:

THREE RIVERS

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