Registration Form

Please complete the registration form for your child and ensure you have read the terms and conditions (these can be found in the 'Terms and Conditions' tab), thank you:

Details of child:

Parent/Guardian details:

Emergency Contact Details (other than named above in the event we cannot get hold of you, who is able to collect your child if necessary):

Medical information about your child:

First Aid Consent

Session Requirements:

Half Breakfast Club (8.00am - 8.45am, no breakfast) Full Breakfast Club (7.30am - 8.45am, includes breakfast which is served between 7.30am - 8.00am)

Half After School Club (3.15pm - 4.30pm) Full After School Club (3.15pm - 6.00pm)


During the course of some Breakfast and After School Club activities, a camera may be available for staff and children to use. It is now necessary to obtain parental permission for photographs to be taken of the children. All photographs taken and printed will be available to parents/carers. Photographs used will not contain any reference to the child's identity etc.

For Reception Children ONLY (Applying sun cream provided by parent/guardian in a named bottle.)

I understand this information will be stored and that Parents/Guardians are responsible for advising the Breakfast and After School Club of any changes.

A registration fee of £10 must be paid with this registration to secure your child's place.

To pay via BACS:

Sort Code: 30-00-02

Account No: 00969317

Account Name: OCC Langford Village Comm DR CR

Reference: Please put your child's name as the reference

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