Welcome to KSA's Ormiston Academy, Brownhills venue Easter Half Term booking form.

Please complete the following:

If you are booking using tax free or childcare vouchers upon completion of this form , please email Claire on: [email protected]

Parents Mobile Number *

1st Child's First Name *

1st Child's Last Name *

1st Child's Date of Birth *

2nd Child's First Name

2nd Child's Last Name

2nd Child's Date of Birth

3rd Child's First Name

3rd Child's Last Name

3rd Child's Date of Birth

Ormiston Venue Days Required

Time slot required *

Has your child (ren) got any medical/additional needs? *

Any additional needs KSA needs to be aware of? *

I will provide my child (ren) with suitable footwear, clothing, hydration & food for snack and lunch times throughout each day attending? *

Yes

I give permission for KSA to administer first aid to my child (ren)? *

Yes

I give consent for my child (ren)'s photo/video to be taken and used for marketing use. *

Yes

What camp would you like your child to attend? You can pick more than 1

I understand failure to turn up or without 7 days notice will still require in FULL PAYMENT being made. *

Yes I understand

How are you going to pay? *

Bank transfer

Government Tax free scheme

Childcare Vouchers

If you are paying with childcare vouchers, which provider will you be using? Your booking via vouchers WILL NOT be confirmed until you send KSA a screenshot of your voucher company authorisation to [email protected] You will liable for such outstanding childcare costs should this not happen.

Costs:

8am - 6:00pm £35 per child per day

9am - 4:00pm £30 per child per day

9am-12:30pm £20 per child per day

1:30pm-6pm £20 per child per day

Please now make the payment.

Booking will NOT be confirmed until payment has been received via bank transfer.

Account Number: 76110525

Sort Code: 04-00-03

Name: The KSAcademy Ltd

In the reference box, please enter:BROWN then your child's full name.