Leicester Outdoor Pursuits Centre Loughborough Road Leicester. LE4 5PN Telephone (0116) 2681426 E-mail:activate@lopc.co.uk
Spring Bank Holiday Scheme 2011 Childs name…………………………………………………………………. (Male / Female) If your child has not attended an Activate Holiday Scheme within the last 12 months or if any details have changed, then please complete a registration form located on our website, or collect one from reception. Tuesday st 31 May
Wednesday st 1 June
Thursday nd 2 June
Friday rd 3 June
Breakfast Club (8am – 9am) £5.00 Under 8 (9am – 5.30pm) £30.00 8-12 yrs (9am – 5.30pm) £30.00 12-15 yrs (9am – 5.30pm) £30.00 Late Collection (5.30pm – 6pm) £2.50 If your child attends the After school Club you will receive a 10% discount. We accept child care vouchers from all leading voucher providers and they can be used in full or part payment for your child’s holiday. If you wish to pay by child care vouchers please tick this box.
A non refundable deposit of 50% is required at time of booking Please note that we no longer accept personal cheques. You can make payment using a debit or credit card by telephone. Declaration
I have fully completed an Up to Date Activate Registration form and all information on it is correct to the best of my knowledge I understand and agree to abide by the terms and conditions as stated in the activate information booklet I will ensure that any outstanding bills are paid by the required date and accept that if failure to do so occurs, my child may loose the opportunity to attend LOPC Activate Holiday scheme I give consent for any emergency treatment in the event of an accident.
Person with Legal parental responsibility (PRINT) ............................................................... DATE……………………………………
(SIGN)..................................................................
STAFF USE ONLY Total Cost £ Date
Payment received
Method (details)
Outstanding
Taken by
Confirmation Sent Ofsted No. 226869
Registered Charity Number 1074671 BCU APPROVED CENTRE AALA APPROVED CENTRE No. L6148/R0628