Apply Online

To apply for a childcare place, please complete the application form below. Alternatively, you can download a printable application form and return to the club manager directly or scan a copy and return via our head office email. (Please note this requires Adobe Acrobat Reader or other PDF viewer to open).

Please note: A copy of this application will go to the email address of Parent/Carer 1.

Club
Please confirm which school your child attends *:

Child Details

Forename(s) *:
Surname *:
Gender *: Male Female 
Date Of Birth *: placeholder "dd/mm/yyyy"
Age *:
Class:
Teacher:

Parent/Carer Details (1)

Title *:
Forenames *:
Surname *:
Address *:
Postcode *:
Home Number:
Work Number:
Mobile Number:
Email Address *:
Relationship To Child *:
Does This Carer Have Legal Responsibility? *:  Yes No

Parent/Carer Details (2)

Title:
Forenames:
Surname:
Address:
Postcode:
Home Number:
Work Number:
Mobile Number:
Email Address:
Relationship To Child:
Does This Carer Have Legal Responsibility?:  Not Applicable Yes No

Emergency Contact 1

Title:
Forenames:
Surname:
Home Number:
Work Number:
Mobile Number:
Email Address:
Relationship To Child:

Emergency Contact 2

Title:
Forenames:
Surname:
Home Number:
Work Number:
Mobile Number:
Email Address:
Relationship To Child:

Medical Details

Doctors Forename(s) or Initial *:
Doctors Surname *:
Surgery Name & Address *:
Does your child have any...
Medical conditions:
Allergies:
Dietary Requirements:

Booking Information
Start Date *:
Please select the Breakfast Club sessions required:  Monday Tuesday Wednesday Thursday Friday
Please select the After School Club sessions required:  Monday Tuesday Wednesday Thursday Friday
Booking Type *:  Permanent (Recurring Weekly) Ad-Hoc (As & When Needed)
Permissions
Do you consent to your child undergoing any emergency medical treatment necessary during the running of the club? *:
 Yes No

Do your authorise the company staff to sign any written forms of consent that are required by the hospital authorities? *:
 Yes No

Should your child need to take medication which has been prescribed by your child's doctor, do you authorise the company staff to administer this medication based on your instructions only? *:
 Yes No

Do you consent to the company staff taking photographs for evidence for Ofsted and other government monitoring groups? *:  Yes No

In the event that another person other than those noted on this application form is needed to collect your child, a security password will be required. Please note that we will not be able to hand over a child to another person without them giving us this password. *:

Please state a password question reminder so that we can ask you this question in the event that you forget your password and need to reset it or inform you of it *:

Please state the answer to your security question above *:

Terms & Conditions

By ticking the box below you are confirming that:
1) This application form has been completed accurately to the best of your knowledge
2) You have read and agree to adhere to all of the companies terms and conditions. These are available here if you have not yet read these. (Please note these open in a separate window.)
3) You agree that both parents/carers with legal responsibility are liable to pay all club fees in accordance with our terms and conditions.
4) You agree to maintain regular and up to date payments of Out of School Club Fees and you understand that to terminate this agreement, four weeks notice or payment in lieu of notice must be given, failure to comply with this may result in loss of placement and legal recovery of amounts outstanding.
5) You understand that this placement must be paid for irrespective of my child being ill or unable to attend.

A copy of this Agreement will be emailed to Parent 1's email address upon submitting. This is a legally binding contract between both Parents/Carer's and Happy Families Childcare Ltd. It is advised that you file a copy of this contract for future reference.

Do you agree to the terms of service? *:  I Agree