(As these sessions get booked up quickly, it is advisable to phone to check availability.)

To book after school club sessions, print out form, fill in details and send to
Kids Can Achieve at Cedars Hall, Chicheley Road, HA3 6QH, including payment.

CHILD'S NAME...............................................................DOB..........................................

ADDRESS..................................................................................................................................

..............................................................................................................................................

EMERGENCY PHONE.....................................................................................................

Please circle sessions requested:

	Mon	Tue	Wed	Thu	Fri
January	16	17	18	19	20
	23	24	25	26	27
	30	31
February			1	2	3
	6	7	8	9	10
	HALF TERM
	CLOSED	21	22	23	24
	27	28	29
March				1	2
	5	6	7	8	9
	12	13	14	15	16
	19	20	21	22	23
	26	27	28	29	30

Any other information we need to know:

...............................................................................................................................................

...............................................................................................................................................

We will be giving the children a light snack e.g. toast/sandwich/crackers. If your child has food allergies or intolerance, please advise.

FOOD ALLERGIES.....................................................................................................

All sessions have to be paid for at the time of booking.

Please make cheques payable to Kids Can Achieve and contact us within a week of sending your cheque to make sure we have received it.