Melton City Council Vacation Care Program Booking Sheet January 2019 – Child Full Name Child Date of Birth Parent/Guardian Full Name Contact Please circle the dates you would like to book M T W T F M T W T F 07/01 08/01 09/01 10/01 11/01 14/01 15/01 16/01 17/01 18/01 21/01 22/01 23/01 24/01 25/01 Booking Agreement I, ___________________________________________________________ name) declare that I am a person with lawful authority for the child referred to in this Booking Sheet understand that the statement provided to me before the program is an estimate only, based on current information provided to the Service by the Department of Human Services (DHS). If there are any changes to my family circumstances or income it is my responsibility to inform the DHS. A final statement will be provided after the completion of the program, which will indicate accurate charges agree that I am liable to pay for all successfully booked days by the due date for payment, regardless of whether my child actually attends the days booked, and understand that failure to do so will result in my booked days being cancelled understand cancellations can only be made up the enrolment close date (as specified on the Activity Flyer), and that cancellations after the enrolment close date will only be accepted at the discretion of program management understand and accept that a late enrolment fee of $21 will be incurred for enrolments after the enrolment close date (as specified on the Activity Flyer) agree to pay a late fee of $5 for the first 5 minutes and $1 per minute thereof per child, for each child if I collect my child(ren) after 6.30pm. Parent/Guardian Signature __________________________________________ Date _________________________ PLEASE TURN OVER TO COMPLETE EXCURSION PERMISSIONS
Melton City Council Vacation Care Program Booking Sheet – January 2019 Child Full Name Child Date of Birth Parent/Guardian Full Name Contact Please circle the dates you would like to book M T W T F M T W T F 07/01 08/01 09/01 10/01 11/01 14/01 15/01 16/01 17/01 18/01 21/01 22/01 23/01 24/01 25/01 Booking Agreement I, ___________________________________________________________ name) declare that I am a person with lawful authority for the child referred to in this Booking Sheet understand that the statement provided to me before the program is an estimate only, based on current information provided to the Service by the Department of Human Services (DHS). If there are any changes to my family circumstances or income it is my responsibility to inform the DHS. A final statement will be provided after the completion of the program, which will indicate accurate charges agree that I am liable to pay for all successfully booked days by the due date for payment, regardless of whether my child actually attends the days booked, and understand that failure to do so will result in my booked days being cancelled understand cancellations can only be made up the enrolment close date (as specified on the Activity Flyer), and that cancellations after the enrolment close date will only be accepted at the discretion of program management understand and accept that a late enrolment fee of $21 will be incurred for enrolments after the enrolment close date (as specified on the Activity Flyer) agree to pay a late fee of $5 for the first 5 minutes and $1 per minute thereof per child, for each child if I collect my child(ren) after 6.30pm. Parent/Guardian Signature __________________________________________ Date _________________________ PLEASE TURN OVER TO COMPLETE EXCURSION PERMISSIONS
sept-2018-booking-sheet.docx