Attention Parents – Vacation Care cut-off date & late booking fee. Due to the large number of parents who were dropping their children off without booking in prior to the start of Vacation Care, we have now found it necessary to implement a strict cut-off date for bookings as at: Monday 21st June 2015 We have strict excursion and incursion child attendance numbers confirmed with our activity providers by Monday 21st June, and will only be able to accept children who have been formally booked in. We cannot guarantee a placement for any child booked in after the above date which may result in your choice of day being full. Late bookings after the cut-off date will attract a “Late Booking Fee” of $5 per child per each day of attendance required, in addition to the regular daily fee. Any changes made to bookings after the cut-off date will be made on a case-by-case basis by Head Office, dependent on the number of children already booked in for that day. This will incur a $2 re-booking fee per child. We appreciate your understanding in this matter and hope your child/ren enjoy the planned activities. OOSH NORTHERN BEACHES Vacation Care Program July 2015 OPERATING HOURS Open from 7.00am to 6.00pm NOTE: On excursion and incursion days, child/ren should be at the centre by no later than 8.45am. Please advise if your child/ren require collection earlier than 3.30pm on any day. Week 1: Monday 29th June to Friday 3rd July 2015 Week 2: Monday 5th July 2015 to Friday 10th July Week 3: Pupil Free Day - Please see note at end of program for forms and dates for your school Location and address Narraweena (St Johns Catholic School) – 166 Alfred Street, Narraweena (entry from Waratah Pde–walk down the pathway to the left of the church) Kids Club Phone: Head Office Phone Contact: 0430 074 015 Ph: 02 9984 8089 Web Page: CCB Fax: 02 9981 2745 Visit our web page www.ooshnb.com.au To receive the childcare rebate, new families need to be CCB accessed. Email: [email protected] Important Note on CCB - Kids Club Vacation Care Provider Number:To receive the 50% Child Care Rebate and Child Care Benefit (CCB) families with a CCB rate must be CCB assessed by ringing FAO (136150). Existing families who have used our service previously and have a current CRN do not need to worry. This is a parent’s responsibility to then advise us. Skater HQ Water Fun Day HAVE YOU VISITED OUR WEBSITE YET? www.ooshnb.com.au Vacation Care Information and Conditions (Important - please read thoroughly) Fees & Closing date: The cost per day is calculated according to the daily excursion and activities. For new families there is an annual OOSH Northern Beaches registration fee of $35.00 / family. This will register families to include future vacation care and before & after school care services for 2015. Due to the Vacation Care program being full on several days, full payment or a payment option selected must accompany this booking form and be received by Monday 21st June, otherwise you will incur the Late Booking Fee or miss out on a space for your child. If payment or a payment option is received then you are guaranteed a place and families do not need to receive a booking confirmation. Refunds: No refunds will be given for absent days. Please contact the centre by 9.00am should your child not be attending on any day. There will be no refunds for sickness, suspension and inability to attend. Authorised Collectors: Emergency contacts are also authorised collectors, however they will need to provide staff with your nominated password (provided on booking form) before allowing them to leave with your child/ren. Sickness: We regret that we are unable to care for sick children. Prescription medication will be administered to child/ren by staff only under written authorisation from parents/guardians. Please do NOT let your child administer medicines themselves. What to bring: Clothing (to get messy/dirty)– Hats and Jumpers that are clearly marked Sunscreen should be applied to your child every day before dropping them to Vacation Care. Sunscreen may be reapplied during the day by staff as deemed necessary, please indicate if you do not wish this to occur. Shoes: closed-in shoes MUST be worn at all times. Bowling & outdoor activities require closed-in shoes/socks. Water bottle and Food: Children are to bring enough food and drink for morning tea and lunch. Afternoon tea is provided unless we are advised your child has any special dietary requirements. Please ensure lunches will not spoil in the warmer days (include an ice pack for example). If your child requires additional food, please include this in their lunchbox. Medication: If your child requires any medication (epi pen, asthma puffer or any other) please make sure that this is handed directly to staff at the beginning of the holidays or alternatively each day your child attends. This is the parents responsibility and we are unable to accept your child without it. PLEASE NOTE NO VALUABLES. Money is not the carers responsibility so please make sure your child has a safe place to keep their money & they know how much they have been given. Excursion information All excursions will begin and end at the centre. No child/ren are to be taken to the excursion site or picked up from the excursion site. On excursion days we usually leave the centre between 8.30am and 9.00am. Please ensure your child is at the centre by 8.45am for a briefing session. Should your child not be present by 8.45am they may miss out on the excursion for the day (a sign will be posted on the door advising the bus has left). We usually return between 3.30pm and 4:00pm. Should you wish your child returned prior to 3.30pm please let the staff know the time you wish your child to return and we will attempt to satisfy this request. Buses used for excursions are driven by a hired bus driver from the supplying bus company with full insurance. Incursion information Children are updated on the rules of travel and behavioural code expected on excursions prior to leaving the centre. We do walk the children the short distance to & from some excursions and this is supervised by our staff, who wear reflective traffic vests. Children are briefed on road rules & safety rules and appropriate behaviour whilst in high traffic environments. However every effort is made to avoid busy areas. St. Johns First Aid recommended first aid kits and asthma kits are taken to all excursions and at least one member of staff holds a senior 1st aid certificate. Any medication that has been signed in by a parent will be included in our 1st aid kit. All staff take excursions very seriously and we have strict guidelines in place. Senior staff members are more than happy to talk you through our excursion procedures at any time. Stay sun smart! It is very important that your children are sun protected. Please make sure that a hat is brought in to wear and sunscreen is applied in the morning. (Staff will reapply when deemed necessary throughout the day). Activities/clothing: Each day apart from the scheduled program, there is sport, games, art & craft experiences provided. Children may bring Board Games & DVD’s at their own risk. Any electronics are not encouraged at the centre and will have time limits applied. On in-centre days, morning tea is at approx. 10.15am & lunch is at approx. 12.30pm. We attempt to have afternoon tea at approx. 3.30pm – 4.00pm, but this is usually prepared by the children so the time may vary slightly (and dependent on the return time from an excursion). Children are to wear clothing appropriate to the daily activities and all belongings should be collected when the children are signed out each day, we cannot take responsibility for clothing left behind each day. Any clothing left at the end of vacation care will be taken to St Vincent De Paul. Behaviour: Disruptive and aggressive behaviour will be dealt with by the staff following the centre’s behaviour management strategies. A report card will be submitted to Head office following disruptive behaviour. Three (3) Report Cards throughout the duration of a full year of vacation care will result in a meeting with the family and Licensee to discuss the suitability of this centre for your child and their attendance. Nuts: Due to increased numbers of children with life threatening allergies to peanuts, we will not allow any peanut butter or nuts to vacation care. If a child consumes peanut butter for breakfast, please wash hands/mouth thoroughly before arriving at the centre. We request your co-operation in this matter. General Information: At kids club we are able to offer lounges for relaxation or watching a movie quietly, outside tennis, soccer, handball, netball or basketball and use of the entire school’s play area and play equipment structure, fully stocked sports equipment, a designated craft area and craft supplies in abundance. Afternoon tea: Afternoon Tea is provided during Vacation Care. This is a snack only and is usually served between 3.30pm and 4.00pm depending on each day’s activities. All of our afternoons are from our healthy eating menu and afternoon tea snacks include; cheese & crackers, sandwiches, lean beef burgers, homemade pizza, pasta, vegetables, milkshakes/smoothies and fruit. If your child needs more than a snack in the afternoon, please provide them with a little more food than usual. OOSH Northern Beaches Fast Fact! Did you know that our Vacation Care has become so popular due to the fantastic program, we are close to full on most days. Book in as early as possible, as certain days will fill quickly. Visit www.ooshnb.com.au for more info! Week 1 July 2015 Monday 29th June Tuesday 30th June Wednesday 1st July Thursday 2nd July Friday 3rd July Incursion Excursion In-House Incursion Excursion The Upside Down Artist FX Zone Sports Centre Winter Wonderland Crazy Scientist Macquarie Ice Rink Hands down, this is the best artist around town and we will get to make our own upside down artwork. We are going to bounce and flip off the walls, and dance under the disco balls at FX Zone Sports Centre & Trampoline Park! Rug up and keep warm with a day of Winter craft, cooking and our own Winter Olympics. The Crazy Scientist is back with his new workshop “Crazy Dinosaurs”. Discover claws, teeth, skulls & even poo! Put ya skates on! We’re going ice skating! Learn to skate or show us your skills as you glide around the rink. Creative Minds Needed. Stretching required! Waiver form to be signed prior to attending Winter Adventures to be had. The biggest fossil collection around town! Brrr… Rug up as it will be icy there. Tacos & Fresh Fruit Party Pies & Sausage Rolls & fresh Fruit Afternoon Tea Spaghetti Bolognaise & Fresh Fruit Crumpets & Pikelets & Fresh Fruit Soup & Toast & Fresh Fruit Week 2 July 2015 Monday 6th July Tuesday 7th July Wednesday 8th July Thursday 9th July Friday 10th July Excursion In House Incursion Excursion Incursion IMAX & Tumbalong Park Drive In Movies Trash Percussion Reptile Park Hip Hop Dance Enjoy a 3D experience unlike anything else watching the movie “INSIDE OUT” at the IMAX. We will then head to the park for a play. “Tuesday at the movies, what picture will we see” Come to our very own drive in movie day where we are going to make our own cars, food to eat and watch some great movies. This workshop is going to be an exciting, vibrant and all-inclusive style of percussion designed with the view that anything and everything can be a musical instrument. Today at the Reptile Park we will see loads of animals, exciting wildlife shows, meet Elvis – the crankiest croc in oz and even walk with Hugo – the giant Galapagos tortoise! Miss Kylie from Plie Groove n Shuffle is back to teach us some funky new moves in this 2 hour fun filled and energetic Hip Hop workshop. Wear your walking shoes. Wear your Pj’s and bring a sleeping bag if you can. Bring your rhythm & beat. We are going to be hands on in this park. “Dancin Shoes is a must”. Toasties & Fresh Fruit Pastry Twists & Fresh Fruit Afternoon Tea Flavoured Rice Cakes & Fresh Fruit Hot Dogs & Fresh Fruit Pizza Wraps & Fresh Fruit PFD 13th July Term 3 Week 1 – Normal School Monday 13th July All Public School students return to school on Tuesday 14th July 2015. Incursion Magic Workshop A workshop jam packed with confidence building magic tricks and our own show bag to take home. How tricky can you be? Afternoon Tea Frogs in a Pond & Fresh Fruit St John’s Catholic School students return to school Tuesday 14th July 2015 St Kevin’s Catholic School students return to school on Monday 13th July 2015. Have you checked your Before and After School Care booking form is up to date? Please email [email protected] with your term 3 form. Pupil Free Day for all Schools will be held at St John’s Kids Club Narraweena. This is within the grounds of St John’s Catholic School behind St John’s Catholic Church Narraweena Please enter off Waratah Parade St John’s Catholic Church St Johns Kids Club Vacation Care & Pupil Free day BOOKING FORM for Vacation Care (to include the Permission Form) All pages either Email to [email protected] or Fax to: 9981 2745 with full payment or a payment option by: Monday 21st June 2015. Forms/bookings will not be accepted if all details on this page are not filled in. Family Details Mothers Name: Date of Birth: Home / Mobile No: Address:: Fathers Name Date of Birth:: Home / Mobile No: Address: Wk Ph: Wk Ph: Main email address: Emergency Contacts: (Must also be authorised collectors with a password or photo ID must be produced) Password: _______________ Contact Name Relationship to Child/ren Home / Mobile Phone: Work Phone: Medical / Health Details Does your child/ren have any medical conditions or dietry restrictions? (e.g. Diabetes, Asthma/Allergies) Please indicate: Yes Doctors name / Phone no: ____________________________________ Is your child immunised? No Childrens Details – If only 1 child attending each day please Indicate either child A or B. Child/ren’s Name Date of Birth CRN (CCB) School Child attends A 2.(B) 1.( ) Days attending: Please indicate which child will be attending each day by circling A and/or B. Permission form over the page must be filled in. Cost is as below per day per child less any CCB – which will automatically be deducted. Week 1 29th June to 3rd July Days Week 2 6th July to 10th July Friday B @ $55 Full – No spaces left Full – No spaces left A B @ $45 A B @ $45 A B @ $55 Full – No spaces left Full – No spaces left A B @ $55 A B @ $55 Total $ Week 3 Pupil Free Day only 13th July A Monday Tuesday Wednesday Thursday $ A B @ $55 Normal School day $ To receive CCB or 50% childcare rebate, the following information is required for new families: Parent nominating as receiving CCB is Mum / Dad (please circle) and their DOB is / / (required) Family CRN _________________________________ Do you have any other child/ren in another form of childcare _______ Yes / No How many? Total Fee Enclosed (For any new families, the 2015 Registration fee of $35 will be added automatically) $ Declaration & Indemnity: I hereby consent to ________________________________________ (child/ren’s name) attending OOSH Northern Beaches (ABN 98 399 800 352) Kids Club Vacation Care. I have read the information and conditions and I agree to abide by them. I give permission for my child to attend any excursions/incursions programmed on the days they are enrolled. I acknowledge that G & PG rated movies may be shown at the centre or cinema. I acknowledge that my child will be exposed to all normal risks associated with participation in the program. I hereby indemnify OOSH Northern Beaches, the Centre’s Licensee Mr. Chris Hegarty, officers, staff and agents, against all claims, demands, actions and liabilities and any responsibility for any accident, loss or injury suffered by my child/ren of any kind arising (other than wilful negligence) in the course of my child’s/children’s attendance. Should at any time OOSH Northern Beaches, its officers, servants or agents consider that my child/ren requires ambulance, medical, dental or hospital assistance, I consent to your obtaining same at my expense. I agree that I will pay all fees and charges and abide by the Policy Document of the Centre & its terms and conditions as varied from time to time and available on request. I have notified all people named on this form as required by the Privacy Act 1998, which came into force in April 2001.I give permission for my child/ren to have their photograph taken & displayed at the Kids Club centre, in the Vacation Care brochure or on the company website Signed: (Parent/Guardian) _______________________ Name in Full _______________________ Date ____/____/____ Permission Form and Payment Options Email: [email protected] or Fax: 9981 2745 TO: Keryn FROM: Date: RE: Vacation Care Permission and Payment form July 2015 EXCURSION AND OTHER PERMISSION FORMS I_________________________ hereby give permission for my child/ren, ________________________ & _______________________to attend the excursion(s) and incursions. On occasion students may also be walking to various excursions (ie: Park Picnic) with staff members. Tick the boxes child/ren are attending. Incursions (where necessary) Imax &Tumbalong Park FX Zone Sports Centre Reptile Park Macquarie Ice Rink I have read and accept all of the above information within the program I have read and signed the waiver form for FX Sports Centre (Tuesday 30th June 2015, if applicable). I have read and signed the waiver form for The Crazy Scientist (Thursday 2nd July 2015, if applicable). signed: ____________________ Name in Full ______________________ Date _____/_____/____ (Parent/Guardian) Payment Option: I wish to pay via the following option: Please tick a payment option: -1 I wish to pay the full amount now, via credit card (please complete No 1 below) - 2 I wish to pay using my existing direct debit authority (please read No 2 below) 1 Credit Card Authorisation Please charge my credit card the total amount of $____________ (less any CCB which I may be entitled to) Card: Visa MasterCard Card Number: ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ __ Expiry Date: ___ ___ / ___ ___ Cardholder Name: _______________________________ Signature: _________________________ Date __ __ / __ __ / __ __ I authorise a variance to the above fee of up to $ 20 (plus or minus) to cover any small credit or outstanding fee that is on my account or a change to my CCB rate which may be applicable at the time. 2 Direct Debit Please use my existing direct debit authority as per my Before and After school care Direct Debit Authority, which will continue to be charged fortnightly on a Tuesday, based on a “end of the current week plus the week before”. All direct debits for Vacation Care will occur on Tuesday 7th July (Week 2 of vacation care) 3 On Line Transfer Information: Should you wish to transfer the fees online please call Head Office on 9984 8089 to discuss. If you are transferring online the total amount will need to be paid. FX ZONE SPORTS CENTRE & TRAMPOLINE PARK - Waiver, Release and Indemnification Agreement PLEASE READ CAREFULLY. BY SIGNING, YOU ARE ASSUMING RISK OF SERIOUS INJURY OR DEATH AND MAY BE GIVING UP IMPORTANT LEGAL RIGHTS. In consideration for being allowed to enter the and/or participate in any activity and/or program (collectively the “Activities”), at HIT & BOUNCE PTY LTD trading as FX Zone Sports Centre & Trampoline Park ABN 66 158 337 690 (hereby known as “FX Zone”), I the undersigned, hereby acknowledge, agree and represent each of the following, on behalf myself and, if applicable, on behalf of any person under the age of 18 for whom I am a parent or guardian (each a “Minor(s)"): 1. I acknowledge and understand that there are inherent risks associated with participation in the Activities at FX Zone, from using trampolines and sporting equipment, and being in close proximity to those engaged in such Activities, including, without limitation, to scrapes, bruises, cuts, and even more serious injuries, such as paralysis or death, and I fully accept and agree to assume all of these risks including risks arising from the negligence of other participants. 2. I and or the Minor(s) are or am voluntarily participating in the Activities including, but not limited to, the use of equipment, facilities, car park and premises. 3. I and or the Minor(s), knowingly and fully assume all risks, associated with participation in the Activities including personal injury, death or disability to me and/or the Minor(s), and waive all claims for damage from all risks associated with participation in the Activities, including risks arising from the negligence of other participants. 4. I understand that the Activities are not a ride or entertainment but rather a physical activity that exposes me and or the Minor(s) to the risks inherent with strenuous physical exertion and stress to which I and/or the Minor(s) will be exposed, and that it may include the risk of bodily injury or death. 5. I have answered the health check for myself and each of the Minor(s), in applicable and each of the following statements is true and complete, and will remain true and completed, at all times when participating in the Activities: a. Neither the Minor(s) nor I have a history of neck, back or heart problems. b. Neither the Minor(s) and/nor I weigh more than 120 kg. Each jumping mat has a bearing capacity of 120 kg. c. Neither the Minor(s) nor I have suffered a shoulder dislocation in the past. d. Neither the Minor(s) nor I is pregnant. 6. I confirm that the answers provided in this form are true and correct and that FX Zone has relied on my answers in allowing me and or the Minor(s) (if applicable) to participate in the Activities. 7. To the extent that the statements in 5a, 5b, and 5c are not true and correct I will inform the receptionist at the premises. I understand and accept that any of the circumstances listed in 5 may increase the risk of injury, disability or death that might result from participation in the Activities and by participating in the Activities I or the Minor(s) accept those risks. 8. I assume all risk of any damage, loss or theft of any personal property that the Minor(s) or I may suffer on the premises including from any locker or safe custody location. 9. I will and I will ensure that the Minor(s) follow all the safety rules of FX Zone. 10. I and/or the Minor(s) accept that FX Zone may, in its absolute and unfettered discretion refuse my and/or the Minor(s) participation in the Activities and or expulsion from the premises. 11. I am/the Minor(s) is, fit to undertake the Activities. Neither I nor any of the Minor(s) (if applicable) suffers from any medical, physical or psychological conditions or is affected by any drugs or alcohol, nor has been advised of any condition by a qualified medical professional that may prevent or restrict me and/or the Minor(s) from participating in the Activities. 12. I represent and warrant that I am over the age of 18 and have the capacity to agree to this release and waiver. Where I am signing on behalf of a Minor(s) I represent and warrant that I am authorised to do so. 13. To the extent permitted by law, including the Competition and Consumer Act 2010, I agree on behalf of myself and/or the Minor(s) and my/their personal representatives, successors, heirs, and assigns to hold FX Zone, its owners, related entities, officers, directors, agents, instructors, employees, and members, as well the property owner and tenants of the property and the owners, sellers, manufacturers and installers of the equipment used in connection with the Activities (collectively, the 'Releasees') harmless from any and all claims or causes of action arising out of my and/or the Minor(s) participation in the Activities. 14. To the extent permitted by law, including the Competition and Consumer Act 2010, I expressly release and discharge the Releasees from any and all liability, claims, demands or causes of action whatsoever arising out of any damage, loss, personal injury or death to me and/or the Minor(s), while participating in any of the Activities, including without limitation, use of the trampolines, Bubble Soccer, pitching, bating and or jumping, receiving instruction, strenuous bodily movement, exposure to extreme conditions, and contact with equipment or machine parts thereof. To the extent permitted by law, this release is valid and effective whether the damage, loss (physical or economic) or death is a result of any act or omission (INCLUDING WITHOUT LIMITATION NEGLIGENCE, GROSS NEGLIGENCE, OR STRICT LIABILITY) on the part of any of Releasees or from any other cause. To the extent permitted by law, this Waiver and Release of all liability includes, without limitation, injuries, illness, or accidents, which may occur as a result of: a. use of the facility or its improper maintenance, b. use of any equipment which may malfunction or break, c. improper maintenance of any equipment, d. instruction or supervision, or e. slipping and falling while in the facility or on the surrounding premises. 15. I acknowledge that I have carefully read this waiver and release, have had the opportunity to obtain advice in relation to the waiver and release, and fully understand that, to the extent permitted by law (including the Competition and Consumer Act 2010) it is a release of all liability and a waiver of any right that I may have on behalf of myself and/or the Minor(s) to bring a legal action or assert a claim for injury or loss of any kind against any of the Releasees. 16. I hereby consent to allow the use of voice, video, image or likeness in photographs and/or video for myself and/or the Minor(s) for use by FX Zone in connection with exhibitions, publicity, advertising and promotional materials without reservation or limitation. 17. By signing this form, I give permission for FX Zone to use my email address to advertise products or promotions related to their company. I also give permission for FX Zone to use my email address to respond to feedback given about FX Zone. 18. I agree that in the event that any provision in this Release and Waiver of Liability is unenforceable under applicable law, the remaining provisions shall be enforced to the fullest lawful extent. Health Check List for: PARTICIPANT NAME Do you have a history of neck, back or heart problems? Does your weight exceed 120 kg?* Have you ever had a shoulder dislocation? Are you currently pregnant?* Age: Yes No * IF you are currently pregnant, or over 120 kg in weight YOU MAY NOT PARTICIPATE IN THE ACTIVITIES WITHOUT EXPRESS WRITTEN APPOVAL FROM YOUR MEDICAL PRACTITIONER By signing this form, I agree and understand that this agreement is binding on myself and the Minor(s). Parent/Guardian Name (please print): ______________________________________________________ Date of Birth: _____ / _____ / ________ Email: ________________________________________________ Signature:_________________________________ Emergency contact (next of kin) Name and phone No.: _____________________________________ Date: _________________________ Participant Name (under 18 y/o) Date of Birth Participant For your fridge (Please remove for your own record) St John’s Kids Club Narraweena, behind St John’s Catholic Church Enter off Waratah Pde, Locations and addresses Narraweena (St John’s Catholic School) – 166 Alfred Street, Narraweena *****enter from Waratah Pde, behind St. John’s Church ***** Kids Club Phone: 0430 074 015 (St John’s, Narraweena) Head Office Ph: 1) 2) 3) 4) Phone: 02 9984 8089 (head office) Fax: 02 9981 2745 Web Page: Visit our web page www.ooshnb.com.au CCB. To receive the childcare rebate, new families need to be CCB accessed Email: [email protected] On excursion days and occasional incursion days, children should be at the centre by 8.45am (at the latest) in preparation for a briefing, final numbering and departure on our bus. Please contact the centre (see above) by 9.00am if your child is not attending any day. On every excursion & incursion children must wear enclosed shoes with socks Our Centre allows for great parking in front of the church. Please do not drive down the driveway or park on the grass area. For your own record circle the days your child is attending, same as those on your official booking sheet and keep this page safe (ie: on the fridge / at work). Days Monday Tuesday Wednesday Thursday Friday Key: Week 1 29 June to 3rd July Week 2 6 July to 10th July Imax & Tumbalong Park Inside Out Movie (Excursion) Week 3 Pupil Free Day only 13th July FX Zone Sports Centre (Excursion) Drive In Movies (In House) Normal School Day – Yay! Winter Wonderland (In House) Trash Percussion (Incursion) Crazy Scientist (Incursion) Reptile Park (Excursion) Macquarie Ice Rink (Excursion) Hip Hop (Incursion) Pink = Excursion – be at the centre by 8.45am Green = Incursion – Be at the centre by 9.30am th Upside Down Artist (Incursion) th Magic workshop (Incursion) No colour = in house – activities all day. All Public School students return to school on Tuesday 14th July. St Johns Catholic School students return to school Tuesday 14th July 2015 St Kevin’s Catholic School students return to school on Monday 13th July 2015. Please see our Pupil Free day Form should you need care. For more information please check your school’s website. Pupil Free Day Booking Form @ Narraweena only Open 7.00am – 6.00pm @ $55 for the day Child 1 Name: ____________________________________ School: ________________________ Child 2 Name: ____________________________________ School: ________________________ Please enrol my child/ren into OOSH Northern Beaches for the nominated Pupil Free Days as below. Parent Name ________________________ Mobile ____________________ Parent Address ________________________ Work & Home_____________ & _____________ Monday 13th July 2015 Held at St Johns Kids Club Narraweena St Johns Catholic School X kids @$55 $ Declaration and Indemnity. I hereby consent to ___________________________________________________________________ (child/ren’s name) attending OOSH Northern Beaches Before and After School Care Centre (from now on referred to as St Johns Kids Club). I acknowledge that my child/children will be exposed to all normal risks associated with participation in activities offered by the St Johns Kids Club. In consideration of St Johns Kids Club admitting my child/children, I hereby agree that I will indemnify the Cromer Public School, the OOSH Northern Beaches Before and After School Care Centre (St Johns Kids Club) the Centre’s Licensee Mr. Chris Hegarty, the St Johns Kids Club’s officers, staff and agents, and keep them indemnified against all claims, demands, actions and liabilities of any kind arising (other than wilful negligence) in the course of my child’s/children’s attendance. I authorise the St Johns Kids Club, the Licensee, it’s officers, servants or agents in the event of any emergency, accident or illness, to obtain such dentist, ambulance, medical and hospital assistance as required, and agree to meet any and all expenses thereby incurred. Signed: ________________________________ (Parent/Guardian) Date: __________________ Please circle Name in full:_____________________________ Payment Option: I wish to pay via the following option: Please tick a payment option: -1 I wish to pay the full amount now, via credit card (please complete No 1 below) - 2 I wish to pay using my existing direct debit authority (please read No 2 below) 1 Credit Card Authorisation Please charge my credit card the total amount of $____________ (less any CCB which I may be entitled to) Card: Visa MasterCard Card Number: ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ __ Expiry Date: ___ ___ / ___ ___ Cardholder Name: _______________________________ Signature: _________________________ Date __ __ / __ __ / __ __ I authorise a variance to the above fee of up to $ 20 (plus or minus) to cover any small credit or outstanding fee that is on my account or a change to my CCB rate which may be applicable at the time. 2 Direct Debit Please use my existing direct debit authority as per my Before and After school care Direct Debit Authority, which will continue to be charged fortnightly on a Tuesday, based on a “end of the current week plus the week before”. All direct debits for Vacation Care will occur on Tuesday 7th July (Week 2 of vacation care)
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