Welcome to KSA's February Half Term booking form.

Please complete the following:

If you are booking using tax free or childcare vouchers, please email Claire on: [email protected]

Parent First Name *

Parent Last Name *

Child's First Name *

Child's Last Name *

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

Venue *

Castle Pool (Castle Vale)

Boldmere Junior School (Boldmere)

Greysbrooke School (Shenstone)

Days Required *

Monday 16th February

Tuesday 17th February

Wednesday 18th February

Thursday 19th February

Friday 20th February

Time Slot Required *

7:30am - 6:00pm Castle Vale Only*

8:00am - 6:00pm

9:00am - 4:00pm

8:00am-12:30pm

1:30pm - 6pm

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

Would you like your child (ren) to be a part of KSA's next billboard campaign? *

Yes

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

Yes I understand

Parents Mobile Number *

Parents Email *

Costs: These Discounted Offers Expire 6th February!

7:30am - 6:00pm Castle Vale Only* £28 per child per day

9am - 4:00pm £24 per child per day

8:00am - 6:00pm £28 per child per day

8:00am-12:30pm £16 per child per day

1:30pm-6pm £16 per child per day

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 code: BD, CV or GY for the venue you are booking. BD Boldmere, CV Castle Vale and GY Greysbrooke. Then your child's full name.