Summer Enrolment Form 2019

Wilnecote Community Leisure Centre
Summer Holiday 2019
WHSKids
Monday 22nd July—Friday 16th August
10% discount before or
on Saturday 13th July

WHSKids
Information
(Ages 5—14, Max Capacity is 60 per day)
There are a wide range of fun activities for all
tastes and abilities. Each day is split into four
sessions. There is a choice of activities which
can include daily swimming*, benchball,
swedish longball, football, hockey, arts and
crafts, quizzes, dance, drama, trampoline,
inflatable sessions and more!
Pricing
Main Scheme Hours
10am—4pm
£12.00
Per child
Per day
Sessions are supervised by DBS checked staff.
Participation is flexible as participants could
attend the whole scheme or single days etc,
whatever suits you!
*Swimming participants will need to prove they can swim a width
across our pool (7 meters) without armbands and swim a length
of our pool with arms bands (17 meters) in order to take part in
these sessions. This is for their own safety.
Full Extended Hours
8:30am—5:30pm
£17.00
Per child
Per day
How to Book Your Place:
1. Complete the enrolment form on the opposite page then
read and sign the sections on the back.
2. Bring the completed enrolment form into the Leisure
Centre, along with payment to confirm your place. For
bookings over £100 a deposit of £100 can be made at the
discretion of Wilnecote Community Leisure Centre
Management. A payment plan for the rest of the balance
will then be agreed.
Please Note the Leisure Centre is open from 4pm each weekday and 9am until 5pm at
weekends, it is not possible to pay outside of these times without making prior
arrangements.
3. Relax knowing the summer holidays are taken care of!
Cheques should be made payable to
Community Academies Trust.

Summer WHSKids 2019: Enrolment Form
Child’s information
Childs Name:
Preferred Name:
Address:
Contact Number:
Postcode:
Email Address:
Age:
Date of Birth:
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?
If Yes, please explain:
Yes/No
Is your child currently taking any prescribed medication?
If Yes, please explain:
Yes/No
Is there anything else you would like the Holiday Scheme staff to know?
Date and Scheme Selection:
On the days you wish to attend choose which scheme you would like to attend using the following code.
M - for Main Scheme
E—for full Extended Scheme
Week
Dates
WHSKids
Monday Tuesday Wednesday Thursday Friday
Amount
paid
Receipt No./
date
Staff
member
E.G 22nd July until 26th July E E M E M
1 22nd July until 26th July
2 29th July until 2nd August
3 5th August until 9th August
4 12th August until 16th August

Consent
1. I agree that the representatives of Wilnecote Community Leisure Centre have my permission to
authorise emergency medical treatment (including anaesthetic) should the need arise in the
judgement of the medical authorities and in the event that my child’s designated emergency
contacts cannot be reached.
2. I agree to photographs and/or video being taken of my child during the WHSkids sessions.
3. 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 leave before this, a member of staff will contact one of the
identified contacts before they are allowed to leave).
Holiday Scheme 2019 Code of Conduct:
All parents/careers are expected to go through the code of conduct with their child/children before arriving at
WHSkids.
Children are expected to behave appropriately and promote a safe, fun and healthy environment through productive
participation. The staff 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.
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.
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.
Communicate in an appropriate manner which means I must not use foul language or gestures, harsh words or
tone of voice.
Conduct myself responsibly. I understand that unwelcome teasing, messing around or other unkind behaviors
are not allowed.
Refrain from deliberately causing bodily harm to other children or staff. I understand that pushing, kicking,
hitting or fighting are not accepted and will not be tolerated.
Use the facility and equipment properly.
Respect the property of others.
Be fully responsible for my actions and understand that irresponsible behaviour will result in disciplinary action.
To be filled in by the child:
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 session for unacceptable behaviour.
Signature:……………………………………………………………………………………
Date:………………………………………………
To be filled in by the parent/carer:
I understand that if my 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 behavior.
Signature:……………………………………………………………………………………
Date:………………………………………………
Keeping Records
Please note the information included in this enrolment form will be held by Wilnecote Community Leisure Centre
until the end of the Summer Holiday scheme. The information will then be destroyed unless you agree to us keeping
your details for the sole purpose of allowing us to contact you about future Wilnecote Community Leisure Centre
activities.
Please sign in this box if we can keep your information after the Holiday Scheme has ended.
The Wilnecote School
Tinkers Green Road
Tamworth
Staffordshire, B77 5LF
01827 831 333
leisure@wilnecotehighschool.org
Thewilnecoteschool.com/leisure