JGS BASC and Holiday Club Contract 2024-25

JGS BASC Contract Jan 25 Onwards

Before & After School Club and Holiday Club
Please note: this contract is for the use of parents/carers who receive payment support only*

*Tax-Free Childcare, Childcare Vouchers, Student Finance and Universal Credit
Child's Details
Child's Name*

First NameMiddle NameLast Name
Child's Date of Birth*

DayMonthYear
Child's Gender*

MaleFemale
School Attended*
School name*
Child's Year*
Child's Class*
Payment Support Information
Which form of payment support do you receive?

Tax-Free childcareChildcare VouchersStudent FinanceUniversal Credit
Tax-Free Childcare reference*
Childcare Voucher Provider*
Allergen / Dietary Information
Does your child have any allergies?*

YesNo
Any known allergies*
Other allergies*
As you have highlighted that your child has an allergy/ allergies you will be sent a Care Plan via email.

Please complete the Care Plan when you have submitted the contract
Special Diet/ Health Requirement/Other*
If none please write N/A
Medication Requirements*
If none please write N/A
Any particular needs of the child- Please specify any additional needs*
If none please write N/A
Are there any indivduals who are unable to have contact with the child?*

YesNo
Are there any court orders in place for the child?*

YesNo
If yes, please upload file

Cancelof

Emergency Contacts
Your Emergency contact must be different from Parents/ Carers.

The Emergency contact will be contacted in the event that the Parents/Carers cannot be reached.

The Emergency contact will also be contacted in the event of a non-collection of a child.

Please note your Emergency Contact must be above 16 years old.
Emergency Contact 1 Name*

PrefixFirst NameLast Name
Emergency Contact 1 relationship to child*
Emergency Contact 1 Phone Number (Mobile)*
Please enter a valid phone number.
Please check your phone number, this number has already been inputted on the form. You will not be able to continue until you change the number.
Emergency Contact 1 Date of Birth

DayMonthYear
Date

	Name	Relationship
Person 1
Person 2

Unauthorised Attendance	Initial £15.00 charge, then £10.00 per half hour
Late Collection	Initial £15.00 charge, then £10.00 per half hour
Late payment of invoice	£20 Admin fee £10 per day fine until payment is made in full
Cancellation of contract	£10.00 per contract

Bank Name	Barclays
Account Name	Jacqueline's Gems Childcare Services Ltd
Sort Code	20-62-69
Account Number	83561216
Reference	Invoice Number/ Child's Name

JGS BASC Contract Jan 25 Onwards