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Summer 26 Ark – Private Registration

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Home
About
Summer Club 2026
Previous Clubs
Signposting & Referrals
Policies
Contact
Summer 26 Ark – Private Registration

Summer 26 Ark – Private Registration

Parent/Carer Details

Full Name *

Email Address *

Mobile Number *

Full Address *

City

Post Code *

Club Choices & Child Details

This form is for the following club

Venue: Ark St Alban's Academy, Conybere St, B12 0YH

Date: Monday 20th July - Wednesday 12th August

Time: 10AM - 2PM

Confirm which weeks your child(ren) will be attending at Ark St Albans Academy *All WeeksWeek 1: Mon 20th July - Thu 23rd JulyWeek 2: Mon 27th July - Thu 30th JulyWeek 3: Mon 3rd Aug - Thu 6th AugWeek 4: Mon 10th Aug - Wed 12th AugYou will be automatically registered onto all four weeks of our programme. Please use this to specify which weeks you will be attending.

How many children do you want to register? *

Child One Details

First Name *

Surname *

Gender *

Date of Birth *

Age *Our holiday is ONLY for young people aged between 6-16

School *

What year group is the child in? *

Is the child eligible for free school meals? *This registration form is for FSM Children only. If you would like to register a Non-FSM child please contact 07954660196

Please enter the child's FSM/Bring it on Brum code *

Does the child have a disability? *

Please provide details *

Does the child have a special education need? *

Please provide details *

Allergies/dietary requirements *

Any other medical conditions or notes *

Ethnicity *

Lunch Option *All meat and chicken is HALAL

Child Two Details

First Name *

Surname *

Gender *

Date of Birth *

Age *Our holiday is ONLY for young people aged between 6-16

School *

What year group is the child in? *

Is the child eligible for free school meals? *This registration form is for FSM Children only. If you would like to register a Non-FSM child please contact 07954660196

Please enter the child's FSM/Bring it on Brum code *

Does the child have a disability? *

Please provide details *

Does the child have a special education need? *

Please provide details *

Allergies/dietary requirements *

Any other medical conditions or notes *

Ethnicity *

Lunch Option *All meat and chicken is HALAL

Child Three Details

First Name *

Surname *

Gender *

Date of Birth *

Age *Our holiday is ONLY for young people aged between 6-16

School *

What year group is the child in? *

Is the child eligible for free school meals? *This registration form is for FSM Children only. If you would like to register a Non-FSM child please contact 07954660196

Please enter the child's FSM/Bring it on Brum code *

Does the child have a disability? *

Please provide details *

Does the child have a special education need? *

Please provide details *

Allergies/dietary requirements *

Any other medical conditions or notes *

Ethnicity *

Lunch Option *All meat and chicken is HALAL

Agreements & Consent

Terms and Conditions

Correct Details

All details and information provided in the form must be accurate. Any false or misleading information may lead to a forfeit of booking, without refund.

Code of Conduct

Our Youth Code of Conduct must be adhered to at all times. Failure to do so will initially result in a verbal warning, repeated failure may lead to the termination of your attendance at the Holiday Club, this will be at the discretion of the Holiday Club Manager. Furthermore, if at any time, an individual’s behaviour poses a threat to the safety of him/herself or others, their attendance at the retreat may be immediately terminated without a verbal warning and will require a parent/guardian to pick them up from the venue.

CLICK THE TICKBOX BELOW

I confirm that I have read and understood the terms and conditions above and I hereby agree with them

I agree to give consent for photos/videos to be taken and to be used on any social media platforms or print material *

Where did you hear about our holiday club? *