October Enrolment Form 2017

Sports and Recreation Sessions,
Monday 23rd October - Friday 27th October
October Half Term!
Activities will include swimming, bench ball, football,
bouncy castles, trampolining, arts and crafts, drama, dance
and much more!
October 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.
Call: 01827 831 333
Email: leisure@wilnecotehighschool.org
Website: thewilnecoteschool.com/leisure
See inside for more information…..

OCTOBER HALF TERM Holiday Activities 2017
Main Scheme Activities
The following activities will take place between 10 am and 4pm, on the dates shown:
WHSKIDS: SPORTS AND RECREATION ACTIVITIES
(Ages 8—14, Max Capacity is 60 per day)
There are a wide range of fun activities for all tastes. Each day is split into four sessions, within
each section there is a choice of activities including a daily swimming session, sports including
bench ball, Swedish long ball, football, hockey etc. as well as arts and crafts, quizzes, dance
tuition and drama games. Every day there will be free play when participants can use bouncy
castles, trampolines and more…
Sessions are supervised by DBS checked staff.
Participation is flexible as participants could attend the whole scheme or odd days, whatever
suits you!
WHSKIDS will take place from Monday 23rd October until Friday 27th October
Main Scheme - Just £12 per day!
One Extended Scheme (either AM or PM) - Just £15 per day!
Full Extended Scheme - Just £17 per day!
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.
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.
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.
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.
Cheques should be made payable to Community Academies Trust. Payment for the week is to
be made before the activities start.

October holiday Scheme 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:
Contact Number:
Relationship to participant:
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.
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.
WHSKIDS
Mon Tue Wed Thurs Fri
Extended
Scheme (AM)
8:30am - 10am
Main
Scheme
10am - 4pm
Extended
Scheme (PM)
4pm - 5:30pm
Attending
(Please tick the boxes for the days and hours you
would like to attend)
For Office Use Only
Total Amount
Cost Per Day
Amount Paid
Receipt Number/Date
Staff Member

Enrolment Form continued
Enrolment Form continued
Consent (Please (Please sign if sign you agree in the with appropriate the following statements) box if you agree with the following statements)
1.)I agree that the representatives of Wilnecote Community Leisure Centre have my permission to authorise
1.)I agree that the representatives of Wilnecote Community Leisure Centre have my permission to authorise emergency medical treatment
Enrolment emergency Form medical continued treatment (including anaesthetic) should the need arise in the judgement of the medical
authorities
(including anaesthetic)
and in the
should
event
the
that
need arise
my child’s
in the judgement
designated
of the
emergency
medical authorities
contacts
and
cannot
in the event
be
that
reached.
my child’s designated
Consent emergency (Please contacts sign cannot if you be reached. agree with the following statements)
2.)I agree to to photographs photographs and/or and/or video being video taken being of my taken child during of my the child WHSKIDs during sessions. the WHSKIDs sessions.
1.) I agree that the representatives of Wilnecote Community Leisure Centre have my permission to authorise emergency
medical
3.)I agree
treatment
to my child’s
(including
name and
anaesthetic)
address being
should
kept on
the
record
need arise
for the
in
purpose
the judgement
of sending
of the
him/her
medical authorities and in the event that
my
information
child’s
about
designated
WHSKIDS
emergency
and the Centre’s
contacts
other
cannot
activities.
be reached.
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
4.)I agree 2.) I that agree my to photographs child is allowed and/or to video walk being home taken without of my a child responsible during the adult WHSKIDS . I understand sessions. that this will mean
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
WHSKIDS staff will allow my child to leave activities at either 4pm or 5:30pm. (Please note if your child wishes to
one of the identified contacts before they are allowed to leave)
leave before this, a member of staff will contact one of the identified contacts before they are allowed to leave)
3.) I agree to my child’s name and address being kept on record for the purpose of sending him/her information about
HOLIDAY SCHEME 2016: CODE OF CONDUCT
WHSKIDS and the Centre’s other activities.
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
HOLIDAY SCHEME 2017: CODE OF CONDUCT
any of our WHSKIDS activities. You are both expected to sign the form stating your acceptance and understanding of it.
You and your child are expected to read this Code of Conduct together in order to help your child behave
Children are expected to behave appropriately and promote a safe, fun and healthy environment through productive participation. The staff
appropriately
4.) I agree
whilst
that
taking
my child
part
is allowed
in any
to
of
walk
our
home
WHSKIDS
without
activities.
a responsible
You
adult
are
.
both
I understand
expected
that
to
this
sign
will
the
mean
form
WHSKIDS
stating
staff will use will a allow positive my approach child to leave to discipline activities and at will either seek 4pm parental or 5:30pm. support (Please to resolve note behavioural if your child issues wishes if required. to leave Children before who this, remain a member disruptive
staff may will be dismissed contact one from of the the programme. identified contacts Please go before through they this are Code allowed of Conduct to leave) with your child to ensure he/she fully understands the
your acceptance and understanding of it.
of
Children are expected to behave appropriately and promote a safe, fun and healthy environment through
expectations.
productive participation. The staff will use a positive approach to discipline and will seek parental support to
As a child on any WHSKIDS Activities Programme, I will:
HOLIDAY resolve SCHEME behavioural 2017: CODE issues OF CONDUCT if required. Children who remain disruptive may be dismissed from the programme.
Show respect to other children and treat them as well as I would like to be treated.
Please go through this Code of Conduct with your child to ensure he/she fully understands the expectations.
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
As a Always child on respect any members WHSKIDS of staff, Activities listen to Programme, instructions so I that will: I know the rules of the session and follow them.
any of our WHSKIDS activities. You are both expected to sign the form stating your acceptance and understanding of it.
Show Respect respect the rights to and other beliefs children of others and with treat courtesy them and as consideration. well as I would like to be treated.
Children are expected to behave appropriately and promote a safe, fun and healthy environment through productive participation. The staff
Communicate in an appropriate manner which means I must not use foul language or gestures, harsh words or tone of voice.
will use
Always
a positive
respect
approach
members
to discipline
of staff,
and will
listen
seek parental
to instructions
support to
so
resolve
that
behavioral
I know the
issues
rules
if required.
of the
Children
session
who
and
remain
follow
disruptive
may Respect be dismissed the rights from the and programme. beliefs of Please others go with through courtesy this Code and of Conduct consideration. with your child to ensure he/she fully understands the
them.
Control my temper.
expectations. Communicate Conduct myself responsibly. in an appropriate I understand manner that unwelcome which means teasing, I messing must not around use or foul other language unkind behaviours or gestures, are not harsh allowed. words
As a child or Refrain tone any from of WHSKIDS voice. deliberately Activities causing Programme, bodily harm I will: to other children or staff. I understand that pushing, kicking, hitting or fighting are not
Show Control accepted
respect my and
to temper. will
other
not
children
be tolerated.
and treat them as well as I would like to be treated.
Always Conduct Use the
respect
facility myself members
and responsibly. equipment
of staff,
properly.
listen I understand to instructions that so that unwelcome I know the teasing, rules of the messing session and around follow them. or other unkind behaviours
Respect are Respect not the
the allowed. rights
property
and
of
beliefs
others.
of others with courtesy and consideration.
Communicate Refrain Be fully responsible from in deliberately an appropriate
for my actions causing manner
and understand
which bodily means harm that
I must
irresponsible to other not use children foul
behaviour
language or will staff. or
result
gestures, I understand in disciplinary
harsh words
action. that or tone pushing, of voice. kicking,
To be filled in by the child:
Control
hitting
my
or
temper.
fighting are not accepted and will not be tolerated.
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
Conduct
Use the
myself
facility
responsibly.
and equipment
I understand
properly.
that unwelcome teasing, messing around or other unkind behaviors are not allowed.
session for unacceptable behaviour.
Refrain
Respect
from
the
deliberately
property
causing
of others.
bodily harm to other children or staff. I understand that pushing, kicking, hitting or fighting are not
Signature:……………………………………………………………………………………
accepted Be fully and responsible will not be tolerated. for my actions and understand that Date:………………………………………………
irresponsible behaviour will result in disciplinary
To be filled in by the parent/carer:
Use
action.
the facility and equipment properly.
To I understand be filled that in by if my the child child: does not follow the Code of Conduct as agreed he/she maybe removed from the session and sent home early. I
Respect the property of others.
I have understand spoken to and my accept child and the they Code are of fully Conduct aware of and the will Code follow of Conduct it at all and times. the consequences I understand of that unacceptable I will automatically behavior. be removed
from Be the fully session responsible for unacceptable for my actions behaviour. and understand that irresponsible behaviour will result in disciplinary action.
Signature:……………………………………………………………………………………
Date:………………………………………………
To be filled in by the child:
Signature:……………………………………………………………………………………
I To understand be filled and in by accept the the parent/carer:
Code of Conduct and will follow it at all times. I understand that I will automatically be removed from the
session I understand for unacceptable that if my behaviour. child does not follow 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
Date:………………………………………………
Signature:……………………………………………………………………………………
behavior.
Contact
Wilnecote
Signature:……………………………………………………………………………………
Community Leisure Centre
Date:………………………………………………
Date:………………………………………………
Address: Wilnecote Leisure Centre, Wilnecote, Tamworth, Staffordshire, B77 5LF
Tinkers Green Road, Wilnecote, Tamworth
Contact
Staffordshire, B77 5LF
Phone: 01827 831 333
Address: Wilnecote Leisure Centre, Wilnecote, Tamworth, Staffordshire, B77 5LF
01827 leisure@wilnecotehighschool.org
831 333
www.wilnecoteleisurecentre.com E-Mail: leisure@wilnecotehighschool.org
Phone: 01827 831 333
E-Mail: leisure@wilnecotehighschool.org
Website: www.wilnecotehighschool.org/leisure
Website: www.wilnecotehighschool.org/leisure