BOSH

Application Form
PLEASE READ INFORMATION NOTES BELOW ON TIMES/COSTS/POLICIES BEFORE APPLYING.
PARENT(S)/GUARDIAN(S)/EMERGENCY CONTACT NUMBERS:
Name: 1 2
Address (inc,
POSTCODE):

Email:
Telephone: Home:
Work:
Mobile:

BREAKFAST CLUB (7.45am to 9.00am) - CHILD(REN) for whom places are required:
Full Name(s) D.O.B. Class Mon Tue Wed Thu Fri
1

AFTER SCHOOL CLUB (3.30pm to 6.00pm) - CHILD(REN) for whom places are required:
Full Name(s) D.O.B. Class Mon Tue Wed Thu Fri
1

NOTES
1. The Out of School Hours Clubs are only open to children at Brookburn Primary School, for term-
time care. Children must be at least 3 years old and in Nursery Class.
2. Fees for places are 5.50 per a.m. session and 8.50 per p.m. session. Discount (2.00 per p.m.
session/1.00 per a.m. session) for siblings when multiple places are taken.
3. Fees are payable monthly IN ADVANCE by Standing Order/eVoucher only and no credit is given
for absence(s). Payments should be made on the 1st of the month. Booked places and extra charges
(e.g. for Late Fees or Extra Ad-hoc sessions) are charged to your account each month, with
statements issued bi-monthly, showing all invoices and payments to date.
4. A Fee Deposit of 50.00 is due on registration (this will be refunded at the end of the school year,
minus any debt collection administration fees).
5. Administration Fees will be charged to your account each time that the BOSH financial
administrator has to initiate the debt collection policy (10.00 for initial reminder letter; 20.00 for
second reminder letter; 20.00 for third and final reminder).
6. The cost of places is subject to change by notice of the BOSH Directors.
7. Place confirmation letters and banking forms will be issued when a place at BOSH has been
allocated. N.B. Places are not guaranteed until your fee-deposit, completed application form
and completed standing order forms have been returned to BOSH Ltd.
8. 4 weeks notice is required, in writing, for cancellation of one or more places.
9. This Applicaton Form, Fee Deposit and Standing Order form should be completed and sent to:
BOSH Ltd., P.O. BOX 126, Manchester, M21 9XT.

WE WILL LET YOU KNOW ABOUT THE RESULT OF YOUR APPLICATION AS SOON AS POSSIBLE
CONSENT & INDEMNITY FORM
I give consent for BOSH staff to act on my behalf in an emergency with respect to the child(ren) named overleaf. I also
give my consent for my child(ren) to go off premises used by BOSH, for official outings only, providing they are
supervised appropriately by BOSH Staff.

While every care and precaution is taken, BOSH Ltd cannot be held responsible for any accidents which may occur.
(BOSH has a comprehensive set of policies, standards and procedures which are all available to view on the BOSH
website at: www.boshonline.com).

MEDICAL INFORMATION (Details of Doctor):

Name:
Address:
Tel. No.:

Please give brief details of any medical problems/known allergies/dietary restrictions, etc.

Is/Are the child(ren) fully immunised? YES / NO

If they have not had and routine vaccinations then please give the details here:

Please indicate here if you have an objection to BOSH publishing photographs of your child on the website. All photos will
be anonymous and will be inline with our website photograph policy (which can be viewed on the website).

CODE OF CONDUCT
By accepting a place for my child(ren) at BOSH I agree to abide by the following code of conduct. N.B. Repeated failure
to follow this code of conduct in the spirit as well as in the substance, will mean that your place(s) at BOSH may be
withdrawn.

1. I agree to pay for my child place(s) one month in advance, due on the first day of the calendar
month.
2. I agree to treat all the dedicated BOSH staff with courtesy and if I have any complaints I will take
these to the Play Manager and if not satisfied with the response I will submit them in writing, or in
person, to the BOSH Directors.
3. I agree to give reasonable notice to the Play Manager when my child is not going to be attending
their normal place at BOSH. If my child(ren) is/are absent from BOSH and the Play Manager has not
been informed, then they will be treated as a missing child, in accordance with BOSH Policies.
4. I agree that on the dropping off of my child(ren) at BOSH they become the responsibility of BOSH
staff, however, on the signing-out of my child(ren) from BOSH they are no longer the responsibility
of BOSH staff.
5. I agree to contacting BOSH if I am going to be delayed in picking up my child(ren) and I understand
that BOSH will charge me a Late Fee of 5.00 to cover the cost of staff remaining behind.
6. I understand that my child place(s) can be withdrawn at any time, if any member of the BOSH Staff
or Management feels that they are being intimidated by a parent/guardian of a child at BOSH.
7. I accept that it is my responsibility to pay my fees and keep track of my account, if my account gets
too far in arrears I will incur administration fees, in accordance with the BOSH Debt Collection
policy.

Signed: . Date: ..

Name: