Registration Form for Midstocket Out Of School Club

Child's first name: *

Child's surname: *

D.O.B: *

Age:

Preferred name:

Student's gender: *

Male

Female

Prefer to self-describe

Is your child currently attending a primary school?: Please note that our holiday club is for primary school-age children only.

Yes

Child’s Current School:

What primary year is your child currently attending: *

Child's home address: *

22 raeden crescent Aberdeen

Post code:

Language(s) spoken at home:

Is English your child's first language?:

Primary contact first name: *

Surname: *

Relationship: *

Address: *

22 raeden crescent Aberdeen ab15 5wj

Contact number: *

Work number:

Email address: *

Are there any other contact restrictions?:

Yes

Details:

Secondary contact first name:

Surname:

Relationship:

Address:

8 Brebner Crescent Aberdeen AB16 7HX

Contact number:

Work number:

Email address:

Custody of the child is with:

Primary contact

Secondary contact

Both (joint custody)

Other

Contact no.1 name: *

Relationship: *

Address (if different from the primary contact):

8 brebner crescent Aberdeen ab16 7HX

Mobile number: *

Work number:

Contact No.2 name:

Relationship: *

Address (if different from the secondary contact):

90 SEAMOUNT COURT, ABERDEEN

Mobile number:

Work number:

I, hereby consent and grant permission to the following persons to collect my child (Must be 18 years or over):

RABI ADAMU, WENDY REID AND ANY OTHER PERSON I MAY AUTHORISE WITH PRIOR NOTICE GIVEN

Allergic reactions - Severity: *

Not Applicable

Very high

High

Medium

Low

Allergies, if any:

Medical conditions, if any:

Does your child have any dietary requirements?:

Yes

Special needs:

Does your child have any special educational needs (SEN)?:

Yes

If your child has any learning difficulties/disabilities or requires additional assistance, please list them here:

Investigating dyslexia.

Any other relevant information we may need to be aware of ?:

No

GP name: *

GP address: *

GP phone number:

Medication (please enter any prescribed medication and dosage):

Religion:

Christian

Muslim

Buddhist

Jewish

Sikh

Hindu

None

Prefer not to say

Others - please state

Other Religion:

Days and sessions required: *

Please read our Terms & Conditions View T&C's

Any other instructions :

Early registration is recommended. Registrations will be considered in the order in which they are received. This form must be signed by the parent(s)/ guardian(s) with parental responsibility; applying for admission of the named child and who it is assumed will be responsible for the fees.

Declaration :

I accept the terms and conditions of the Midstocket Out of School Club

Yes No

Full Name of Parent/Carer:

Digital Signature

Meggan Mckenzie

Date & time:

06, Feb 2026 09:55 pm

Midstocket Out of School Club

Profile

Contacts

Emergency

Health

Other

Consents

Terms