Summer Enrolment Form 2017

Wilnecote Community
Leisure Centre
Information and Enrolment Form for activities including:
WHSKIDS
Sports and Recreation Sessions,
Everyday
Week One Until Week Five
Monday 24th July until Friday 25th Aug
Main Scheme Day = £12 (£10.80 if booked before 9th July)
Extended Scheme Day = £17 (£15.30 if booked before 9th July)
Theatre Skool
Week Two Only
Monday 31st July until Friday 4th August
Main Scheme Week = £100 (£90 if booked before 9th July)
Extended Scheme = £125 (£112.50 if booked before 9th July)
Week Three Only
Monday 7th August until Friday 11th August
Main Scheme Week = £75 (£67.50 if booked before 9th July)
Extended Scheme Week = £100 (£90 if booked before 9th July)
Discount Day Sunday 9th July 2017
Main Scheme:
10:00am until 4:00pm
Extended scheme:
Drop off between 8:30am and 10:00am
and/or
Pick up between 4:00pm and 5:30pm
To Book Contact Us:
Wilnecote Community Leisure Centre
The Wilnecote School
Tinkers Green Road, Wilnecote, Tamworth
B77 5LF.
Tel: 01827 831 333
Email: leisure@wilnecotehighschool.org
Web: www.wilnecotehighschool.org/leisure/
See inside for more information…..

:
All of the following activities will take place between 10am and 4pm, on the dates shown.
WHSKIDS: SPORTS AND RECREATION ACTIVITIES (Ages 8—14, Max Capacity is 60 per day)
A wide range of fun activities for all tastes. Each day is split into three sessions, each with a choice of activities including
a swimming, benchball, Swedish longball, football, hockey, arts and crafts, team games, dance, drama games and
more…
Our activities timetable is flexible and will be based on requests, weather etc but you can visit our website to find out
information about the range of activities at www.wilnecotehighschool.org/leisure/
Sessions are all supervised by DBS checked staff
Participation is flexible, you can choose to attend the whole scheme, full weeks or occasional days, whatever suits you!
WHSKIDS will take place Week 1 until Week 5 (Every weekday from Monday 24th July until Friday 25th August.).
Theatre Skool (Ages 8—14, Max Capacity is 15 for the week)
Participants will take to the stage with our fantastic week of drama based fun and games. Participants will write the
script, choreograph dance routines, design costumes, make props and produce their own unique show under the
supervision of our Drama Tutors.
Participants are expected to attend everyday and must stay until 5:30pm on the Friday.
Theatre Skool will take place during Week 3 (Monday 7th August until Friday 11th August.).
PLEASE NOTE: friends and family will be invited to the performance which will take place at 5pm on Friday 11th of
August.
(Ages 8—14, Max Capacity is 25 per week)
Lights Camera Action Participants will work with our Performing Arts Technician and our drama tutor to produce, direct
and star in their very own feature film. In previous years participants have recreated music videos, put their own spin
on famous films and TV shows, created an anti bullying video and created adverts for many products and services.
Participants are expected to attend the full week
Summer Holiday Activities 2017
Film and Camera Club will take place on Week 2 (Monday 31st July until Friday 4th August)
PLEASE NOTE: Participants will be filmed therefore by joining this scheme you agree for your child to be filmed and
have the final product accessible on online.
Extended Scheme:
Ideal for working parents our Extended Activities take place between 8:30am and 10am in the morning and from 4pm
until 5:30pm in the afternoon. Participants from all of the above activities can take part providing the perfect start
and/or end to their day.
Activities are more relaxed than the Main Schemes and include filtered internet access, board games, games console
competitions, pool, table football, arts and crafts, sports, films and TV, and other activities ideal for waking up and
cooling down.
To attend a morning session (8:30am until 10:00am) or an afternoon session (4:00pm until 5:30pm) there is an
additional £3.00 cost per day
To attend both sessions there is an additional £5.00 cost per day.
How to book your place:
Our enrolment form section is opposite. Please complete all of the requested information including signing the
permissions and the code of conduct on the back page. In the activity selection section please tick an activity
(e.g. Theatre Skool) and a scheme (e.g. main scheme) for each week you wish to attend. For WHSKIDS bookings it is
possible to book single days. Please leave activities you do not wish to attend empty. The blacked out boxes indicate
that activity will not be running that week.
Please Note activities are dependent on a minimum and maximum number attending so places can not be guaranteed,
however we will endeavour to run all activities or find places for participants in other activities.
Cheques should be made payable to Community Academies Trust . Payment for each week is to be made before the
activities start.

Summer holiday activities 2017: Enrolment Form
Childs Name:
Preferred Name:
Address :
Contact Number:
Postcode:
Email Address:
Age:
Date of Birth:
School Attended:
Emergency Contact 1 Emergency Contact 2
Name:
Relationship to Participant:
Contact Number:
Name:
Relationship to participant:
Contact Number:
Doctors Name:
Surgery:
Contact Number:
Does your child have any known medical conditions or allergies?
Yes/No
If Yes, please explain:
Is your child currently taking any prescribed medication?
Yes/No
If Yes, please explain:
Is there anything else you would like the Holiday Scheme staff to know?
Activity Selection
1.) Decide which activities you would like to participate in e.g. WHSKIDS.
2.) Tick the days you would like to attend. (Please note both Theatre Skool and Film and Camera Club require full week attendance)
3.) Choose your timings e.g. if needed you can attend our extended hours in the morning (8:30am until 10am)
and/or in the afternoon (4pm until 5:30pm)
4.) Based on this information tick the appropriate boxes.
5.) Complete the enrolment form and return to Wilnecote Community Leisure Centre.
If you require a mixture of Main Scheme and Extended hours within the same week please speak to a member
of staff before completing the form.
Wk.
Dates
WHSKIDS
Mon Tue Wed Thurs Fri
Theatre
SKooL
Film and
Camera Club
Extended
Scheme (AM)
Extended
Main Scheme
Scheme (PM)
1 24th July until 28th July
2 31st July until 4th Aug
3 7h Aug until 11th Aug
4 14th Aug until 18th Aug
5 21st Aug until 25th Aug

Enrolment Form continued
Consent (Please sign in the appropriate box if you agree with the following statements)
1.)I agree that the representatives of Wilnecote Community Leisure Centre have my permission to authorise
Enrolment emergency medical Form continued
treatment (including anaesthetic) should the need arise in the judgement of the medical
authorities Consent (Please and sign in if the you event agree with that the my following child’s statements) designated emergency contacts cannot be reached.
1.) I agree that the representatives of Wilnecote Community Leisure Centre have my permission to authorise emergency medical
2.)I agree treatment to photographs (including anaesthetic) and/or video should being the need taken arise of in my the judgement child during of the the medical WHSKIDs authorities sessions. and in the event that my
child’s designated emergency contacts cannot be reached.
3.)I agree
2.) I
to
agree
my
to
child’s
photographs
name
and/or
and address
video being
being
taken
kept
of my
on
child
record
during
for
the
the
WHSKIDS
purpose
sessions.
of sending him/her information
about WHSKIDS and the Centre’s other activities.
3.) I agree to my child’s name and address being kept on record for the purpose of sending him/her information about WHSKIDS
and the Centre’s other activities.
4.)I agree that my child is allowed to walk home without a responsible adult . I understand that this will mean
WHSKIDS staff will allow my child to leave activities at either 4pm or 5:30pm. (Please note if your child wishes to
4.) I agree that my child is allowed to walk home without a responsible adult . I understand that this will mean WHSKIDS staff will
leave before this, a member of staff will contact one of the identified contacts before they are allowed to leave)
allow my child to leave activities at either 4pm or 5:30pm. (Please note if your child wishes to leave before this, a member of staff
will contact one of the identified contacts before they are allowed to leave)
HOLIDAY SCHEME 2017: CODE OF CONDUCT
HOLIDAY SCHEME 2017: CODE OF CONDUCT
You and your child are expected to read this Code of Conduct together in order to help your child behave
You and your child are expected to read this Code of Conduct together in order to help your child behave appropriately whilst taking part in
appropriately whilst taking part in any of our WHSKIDS activities. You are both expected to sign the form stating
any of our WHSKIDS activities. You are both expected to sign the form stating your acceptance and understanding of it.
your acceptance and understanding of it.
Children are expected to behave appropriately and promote a safe, fun and healthy environment through productive participation. The staff
Children are expected to behave appropriately and promote a safe, fun and healthy environment through
will use a positive approach to discipline and will seek parental support to resolve behavioral issues if required. Children who remain disruptive
may be dismissed from the programme. Please go through this Code of Conduct with your child to ensure he/she fully understands the
productive participation. The staff will use a positive approach to discipline and will seek parental support to
resolve behavioural issues if required. Children who remain disruptive may be dismissed from the programme.
expectations.
Please go through this Code of Conduct with your child to ensure he/she fully understands the expectations.
As a child on any WHSKIDS Activities Programme, I will:
As a child on any WHSKIDS Activities Programme, I will:
Show respect to other children and treat them as well as I would like to be treated.
Show respect to other children and treat them as well as I would like to be treated.
Always respect members of staff, listen to instructions so that I know the rules of the session and follow them.
Always respect members of staff, listen to instructions so that I know the rules of the session and follow them.
Respect the rights and beliefs of others with courtesy and consideration.
Respect the rights and beliefs of others with courtesy and consideration.
Communicate in an appropriate manner which means I must not use foul language or gestures, harsh words or tone of voice.
Communicate in an appropriate manner which means I must not use foul language or gestures, harsh words
Control my temper.
or tone of voice.
Conduct myself responsibly. I understand that unwelcome teasing, messing around or other unkind behaviors are not allowed.
Control my temper.
Refrain from deliberately causing bodily harm to other children or staff. I understand that pushing, kicking, hitting or fighting are not
Conduct myself responsibly. I understand that unwelcome teasing, messing around or other unkind behaviours
accepted and will not be tolerated.
are not allowed.
Use the facility and equipment properly.
Refrain from deliberately causing bodily harm to other children or staff. I understand that pushing, kicking,
Respect the property of others.
hitting or fighting are not accepted and will not be tolerated.
Be fully responsible for my actions and understand that irresponsible behaviour will result in disciplinary action.
Use the facility and equipment properly.
To be filled in by the child:
Respect the property of others.
I understand and accept the Code of Conduct and will follow it at all times. I understand that I will automatically be removed from the
Be fully responsible for my actions and understand that irresponsible behaviour will result in disciplinary
session for unacceptable behaviour.
action.
Signature:……………………………………………………………………………………
To be filled in by the child:
Date:………………………………………………
To I understand be filled in by and the accept parent/carer: the Code of Conduct and will follow it at all times. I understand that I will automatically be removed
I from understand the session that if for my unacceptable child does not follow behaviour. the Code of Conduct as agreed he/she maybe removed from the session and sent home early. I
have spoken to my child and they are fully aware of the Code of Conduct and the consequences of unacceptable behavior.
Signature:……………………………………………………………………………………
To be filled in by the parent/carer:
Signature:……………………………………………………………………………………
Date:………………………………………………
I understand that if my child does not follow the Code of Conduct as agreed he/she maybe removed from the session and sent
Wilnecote Community Leisure Centre
Date:………………………………………………
home early. I have spoken to my child and they are fully aware of the Code of Conduct and the consequences of unacceptable
behavior.
Tinkers Signature:……………………………………………………………………………………
Green Road, Wilnecote, Tamworth
Date:………………………………………………
Staffordshire, B77 5LF
01827 leisure@wilnecotehighschool.org
831 333
DISCOUNT Day Information
www.wilnecoteleisurecentre.com
10% OFF when bookings are made on or before Sunday 9th July 2017
Come and visit us on Sunday 9th July between 2:30pm and 4:30pm, see our facilities and take part
in some of some fantastic taster activities. It’s the ideal time to check if our scheme is right for you!
Any booking made on or after Sunday 9th of July will be charged at the full cost with only a 10% Sibling Discount available to the
second and any additional sibling from the same family..