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BOSS Registration Form

This document is a registration form for Burntisland Out of School Service (BOSS) that was published in May 2012. It requests contact and medical information for children who will use the after school care service. Parents must provide at least two emergency contacts and consent for their children to participate in activities away from the premises, be photographed or receive medical treatment if needed. The form details the annual registration fee, policies around payment of monthly fees, cancellations, late pickups, and medication requirements. Parents must sign accepting the conditions of service for their children to use BOSS.

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153 views

BOSS Registration Form

This document is a registration form for Burntisland Out of School Service (BOSS) that was published in May 2012. It requests contact and medical information for children who will use the after school care service. Parents must provide at least two emergency contacts and consent for their children to participate in activities away from the premises, be photographed or receive medical treatment if needed. The form details the annual registration fee, policies around payment of monthly fees, cancellations, late pickups, and medication requirements. Parents must sign accepting the conditions of service for their children to use BOSS.

Uploaded by

gillian7108
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BOSS Registration form- Published May 2012

TO

BURNTISLAND OUT OF SCHOOL SERVICE

Registration form
All information supplied by Parents/Guardians will be treated as Private and Confidential by all Employees at BOSS. The information will be securely stored and supplied to Staff on a need to know basis. Parents/Guardians will have access to their child's record on request. This document is a contract between the signatory and Burntisland Out of School Service. If you wish to view any of the policies and practices which govern the safe running of our service please contact the BOSS Manager.

Terms & Conditions:


I will notify BOSS if there are any changes in my circumstances, especially contact details. I will notify BOSS via telephone at least 20 minutes before the end of the school day if my child(ren) is/are not in school on a day they are expected at BOSS. I will notify BOSS of any medication requirements for my child(ren) and complete the required consent form. I will notify BOSS if my child(ren) are to be collected by someone other than those adults detailed on this form.

Primary contact:
Name: Address: Primary contact number: Work / Home / Mobile Work address:

Post code: Email address: Relationship to child:

Home Telephone: Mobile Number: Work Telephone:

1|P age BOSS at Toll Centre, East Toll Park, Burntisland, Fife, KY3 9HA Tel & Fax: 01592 872854 Mobile: 07980429040 Email: [email protected]

BOSS Registration form- Published May 2012

Note: At least two alternate contacts must be provided who are able to respond in an emergency situation. Please ensure you include anyone who may collect your child(ren) from BOSS in your absence. Alternate contact 1: Name: Relationship to child: Permission to collect your child(ren) from BOSS

Home Telephone: Mobile Number: Work Telephone:

Alternate contact 2: Name: Relationship to child: Permission to collect your child(ren) from BOSS

Home Telephone: Mobile Number: Work Telephone:

Alternate contact 3: Name: Relationship to child: Permission to collect your child(ren) from BOSS

Home Telephone: Mobile Number: Work Telephone:

Alternate contact 4: Name: Relationship to child: Permission to collect your child(ren) from BOSS

Home Telephone: Mobile Number: Work Telephone:

Family Doctor details:


Name: Telephone: Additional Information: Address:

2|P age BOSS at Toll Centre, East Toll Park, Burntisland, Fife, KY3 9HA Tel & Fax: 01592 872854 Mobile: 07980429040 Email: [email protected]

BOSS Registration form- Published May 2012

Child 1:
Name: School: Term time Days Required: Monday Tuesday Medical conditions: D.O.B.: Class:

Wednesday

Thursday Medication:

Friday

N/A

Allergies:

Other Information:

Child 2:
Name: School: Term time Days Required: Monday Tuesday Medical conditions: D.O.B.: Class:

Wednesday

Thursday Medication:

Friday

N/A

Allergies:

Other Information:

Child 3:
Name: School: Term time Days Required: Monday Tuesday Medical conditions: D.O.B.: Class:

Wednesday

Thursday Medication:

Friday

N/A

Allergies:

Other Information:

3|P age BOSS at Toll Centre, East Toll Park, Burntisland, Fife, KY3 9HA Tel & Fax: 01592 872854 Mobile: 07980429040 Email: [email protected]

BOSS Registration form- Published May 2012

Consent required: I consent / do not consent for my child(ren) to attend activities outside of BOSS premises as part of the programme. I consent / do not consent for my child(ren) to be videoed or photographed participating in BOSS Activities and understand that these photos may be used by BOSS in future publicity, funding applications, funding reports or for use by local press. I consent / do not consent to any emergency medical/dental treatment being carried out as necessary. I consent / do not consent to BOSS Staff assisting, if necessary, with the application of sun screen that I have provided for my child(ren). Fees / Attendance: Upon registration an administration fee of 15 is required - this payment will begin in August 2012 for the 2012/2013 school year. This is an annual fee and is payable in August of each year, irrespective of when you started using the service during the school year. Fees for term-time attendance and play schemes will be reviewed on an annual basis, updates will be applied at the start of each school year. Once your child(ren) start attending, your childcare will become a permanent arrangement during term-time, thereafter we will require four weeks written notice to cancel or change days of attendance as well as four weeks' notice when you terminate your childcare. Details of fees, methods of payment and the due dates for fees are shown on the accompanying calendar (available from June 2012). Fees for the service must be paid monthly in advance and failure to pay these in time may result in the service being withdrawn. Places booked but unused for any reason will be charged at the full amount during term-time. Full fees will still be payable when a child(ren) is off ill. If your child(ren) is off school then you must inform BOSS by telephone at least 20 minutes before the end of the school day to ensure we do not wait on your child(ren) after school. Late collection fees will apply and are charged for every part or whole 15 minute period after 6pm. These are payable within seven days. Allocated days may be changed or swapped with at least 48 hours notice and will be provided subject to availability. Acceptance: I have completed the information as accurately as I am able and understand the conditions detailed above for use of Burntisland Out of School Service and agree to abide by these.

Signed (Parent / Carer)

Date

4|P age BOSS at Toll Centre, East Toll Park, Burntisland, Fife, KY3 9HA Tel & Fax: 01592 872854 Mobile: 07980429040 Email: [email protected]

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