SHERE FUN HOLIDAY PLAYSCHEME

Note This sheet should be submitted with the Care Information Sheet on this site

CHILD INFORMATION SHEET

SEPARATE FORM FOR EACH CHILD

CHILD

Full Name___________________________________________________________
Name "prefers to be called by"_________________________________________
Home Address_______________________________________________________
_______________________________________________Post Code___________
Telephone__________________________________________________________
Age________________________Date of Birth_____________________________
School Attended_____________________________________________________

PARENT

Name______________________________________________________________
Work Contact: Company/Organisation___________________________________
Department_________________________________________________________
Address____________________________________________________________
_____________________________________________________________

Telephone___________________________________________________________

CONTACTS IN CASE OF AN EMERGENCY

(OTHER THAN PARENT NAMED ABOVE)

1. NAME_________________________________________________________
ADDRESS______________________________________________________
______________________________________________________
TELEPHONE____________________________________________________

2. NAME__________________________________________________________
ADDRESS______________________________________________________
______________________________________________________
TELEPHONE____________________________________________________
 

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