FEBRUARY HALF-TERM HOLIDAY COURSES APPLICATION FORM 2019

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FEBRUARY HALF-TERM HOLIDAY COURSES APPLICATION FORM 2019 Please tick your chosen date(s) and complete the application form. Full course fees are required at the time of booking. Please return fully completed forms by Wednesday 13 February 2019 via: Hand: School Reception or the Bursary Post: Loughborough Schools Foundation Holiday Courses 3 Burton Walks Loughborough LE11 2DU Email: holiday.courses@lsf.org LSF FAIRFIELD PRE PREP COURSE 18 February 2019 KG Yr 2 32 Extended Day 8 19 February 2019 KG Yr 2 32 Extended Day 8 20 February 2019 KG Yr 2 32 Extended Day 8 21 February 2019 KG Yr 2 32 Extended Day 8 22 February 2019 KG Yr 2 32 Extended Day 8 Full Week (5 Days) KG Yr 2 135 Extended Day 40 REF: HCPP1 LSF COMPUTING & STEM COURSE 18 February 2019 Yr 5 Yr 8 32 Extended Day 8 19 February 2019 Yr 5 Yr 8 32 Extended Day 8 20 February 2019 Yr 5 Yr 8 32 Extended Day 8 21 February 2019 Yr 5 Yr 8 32 Extended Day 8 22 February 2019 Yr 5 Yr 8 32 Extended Day 8 Full Week (5 Days) Yr 5 Yr 8 135 Extended Day 40 REF: HCCS1 TEAM:FIT FUN Dates Age Booking Contact Details 18-22 February 2019 4 11 sarah@teamfitfun.co.uk sa TEAM:FIT FUN - EXTENDED DAY BOOKING ONLY 18 February 2019 R Yr 6 Extended Day 8 19 February 2019 R Yr 6 Extended Day 8 20 February 2019 R Yr 6 Extended Day 8 21 February 2019 R Yr 6 Extended Day 8 22 February 2019 R Yr 6 Extended Day 8 Full Week (5 Days) R Yr 6 Extended Day 40 REF: HCED1 Page 1 of 5

TO BOOK LSF COURSES ABOUT YOUR CHILD Surname: First Date of Birth: DD/MM/YYYY Age at time of Course: School Year: Boy School Fairfield Prep School Girl Loughborough Grammar School Loughborough High School Loughborough Amherst School Please state any allergies, medical conditions or special dietary requirements (if none state n/a) Doctor s Surgery: Surgery Tel: ABOUT YOU Title (Mr, Mrs, Ms) Address: Page 2 of 5

Home Tel: Email: Please provide two emergency contact telephone numbers: Relationship to attendee: Relationship to attendee: I understand and accept all Terms & Conditions. Please sign in order to process your application. Signed: Print Date: DD/MM/YYYY Photography: We may take still/video images during our courses for the purpose of evaluation, producing promotional material and for sharing on social media. We would be grateful for your consent to use such images. I have read the above and consent that Loughborough Schools Foundation may take, store and use images of my child/ren as described above. YES / NO (Please delete as appropriate). Signed: Date: DD/MM/YYYY Page 3 of 5

COURSE PAYMENT I wish to pay full course fees per child, per course. Course Reference: Amount Paying: Method of Payment I will be paying by (tick the appropriate method) Cheque payable to Loughborough Schools Foundation Credit/Debit Card (please fill in details below) Please debit my Mastercard Visa Solo Visa Debit Card Number Expiry Date Valid From Issue No CVV No / / / _ Card holder s name (Please print) Card holder s signature Date DD/MM/YYYY Debit/Credit card details will not be retained after payment in full has been completed. Childcare Vouchers Voucher Provider: Please use Fairfield Prep School as the carer. Reference used should be course reference followed by child s name. Once the payment request has been made to the Voucher Provider please email holiday.courses@lsf.org to state that the payment request has been made. No booking is secure without an email to inform us of the Childcare Voucher provider, the anticipated date for payment and the amount. Failure to add the appropriate reference and send an email will cause delay in confirmation of the place. Page 4 of 5

LOUGHBOROUGH SCHOOLS FOUNDATION HOLIDAY COURSES TERMS AND CONDITIONS When making a booking, a completed application form and payment must be made in full for each child, in order to secure a place on a Loughborough Schools Foundation Course. Written confirmation of the receipt of the booking form and payment will be sent to all parents with any additional information about the course if necessary. Refunds will be given in the event of any Loughborough Schools Foundation course being cancelled by Loughborough Schools Foundation. All fees paid will be forfeited by anyone cancelling a course within 14 days of the course start date. Loughborough Schools Foundation Courses will run subject to minimum numbers being met. In the event that minimum numbers are not met, we will endeavour to provide a suitable alternative. If a course is full, names will be added to a waiting list on a first come first served basis. Please note that this does not guarantee a place on the course. You will be contacted prior to the course if a place becomes available. The deadline for receipt of application forms is 48 hours before the applicant s first proposed day of participation. There is no guarantee that a course can be offered after this time, therefore, please do not arrive on the first day of the course expecting a place as there may not be one available. Loughborough Schools Foundation reserves the right to withdraw any child from a course for behaviour that we deem to be detrimental to the smooth running of the course or which might interfere with the safety of any other participants on the course. Regulations made for the safety and comfort of course members must be observed. Loughborough Schools Foundation cannot accept responsibility for any personal loss or damage to property or any injury sustained by participants. Qualified medical staff will be onsite at all times in case of any incidents requiring medical attention. Please refer to terms and conditions for holiday courses supplied by third parties. Loughborough Schools Foundation cannot accept responsibility for the running of their courses. January 2019 Page 5 of 5