Vacation Care Program Booking Form 22th September – 3rd October 2014 If you have not used the service before you will need to complete a separate enrolment form

PLEASE PRINT CLEARLY PARENT/ CARER NAME AND DETAILS Family name : _________________________________________________________________________ First name : __________________________________________________________________________ E-mail : ________________________________________________________________________ Home Phone : _________________________________________________________________________ Work Phone : _________________________________________________________________________ Mobile Phone : ________________________________________________________________________

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I/We agree to the terms and conditions of enrolment in relation to my child’s /children’s attendance at Avoca Before & After School Care and agree to abide by the fees and accounts policy of the Service. If I have enrolled my child on an excursion or activity day I understand the risks inherent in the activity and give permission for my child to partake in that activity / go on that excursion. I understand that if my child’s behavior represents a risk to themselves or others I will be contacted to arrange for him/her to be collected from the service as soon as possible. I give my permission for photographs of my children to be taken for display purposes I understand that my booking is not confirmed until payment of 50% of the estimated fee is received and that late fees will apply if my account is not paid by the due date. My Centrelink % is ………………………..% I undertake to pay my account Direct Deposit to the Service Account.(Circle)

Full Name of Parent or Guardian _______________________________________ Signature___________________________________________________________ Date_______________________________________________________________

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Bank Account Avoca School Care Name of Financial Institution: Newcastle Permanent Account holder: Avoca School Care BSB No: 650 300

Account Number: 9797 72809

Full Name of each child attending on this day PLEASE PRINT CLEARLY

Monday 22/09/2014 Scouts Day ($50,00)_____________________________________________________________________ Tuesday 23/09/2014 Let’s do a Day in Italy ($50,00)____________________________________________________________ Wednesday 24/09/2014 Drumbala is coming to us ($70,00)______________________________________________________ Thursday 25/09/2014 All things scientific ($50,00)______________________________________________________________ Friday 26/09/2014 Tennis Coaching ($65,00)___________________________________________________________________

Monday 29/09/2014 Puppet day ($50,00)____________________________________________________________________ Tuesday 30/09/14 Fitness day ($50,00)_______________________________________________________________________ Wednesday 1/10/2014 Avoca paddle boats ($70,00)_____________________________________________________________ Thursday 2/10/14 Hip Hop day ($65,00)______________________________________________________________________ Friday 3/10/2014 Jumping castle and party ($60,00)____________________________________________________________

Monday 6/10/2014 PUPIL FREE MONDAY, please fill in if you need care ___________________________________________

Please complete the form and bring it back into our office, thank you!

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