Date

MM

DD

YYYY

Child's Name *

First Name

Last Name

Parent's Name *

First Name

Last Name

Holiday Start *

Please note that we are away during school holidays and our children will not be attending the centre

MM

DD

YYYY

Holiday End *

MM

DD

YYYY

First Day Back *

Our first day of attendance back at the Centre will be

MM

DD

YYYY

I understand that fees are still chargeable during this time. *