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May 2019-book now!
May 2019-book now!
Warwick Holiday Scheme booking form online payment
May 2019- Warwick Holiday Scheme booking form online payment
Please complete a separate booking form for each child and have your credit/debit card details ready. Please note that you will not be able to save the form and return to it later or make any changes to your booking online once it is submitted.
Full name - parent/carer
User code (if you are not a member of the University please write n/a)
Department/organisation (if you are not a member of the University please write n/a)
Telephone contact number
Alternative phone number
Address line 1
Address line 2
Town or city
Child - first name
Child - surname
Prefer not to say
Child religion- if other please describe
Child- first language if different from English
Child’s school year in September 2018
Please list important medical conditions and/or special educational needs and/or special dietary requirements in the space below. This includes those prohibited by religious or cultural beliefs. If n/a please note.
If your child has a medical condition/special educational need/ special dietary requirement that needs to be discussed in more detail with a member of staff please email
to arrange a meeting. We will make all reasonable adjustments to accommodate your child needs.
Child- name of Doctor
Child- address of Doctor
Child- contact number for Doctor
I am also submitting a separate form(s) for sibling(s) of this child to attend the Scheme
Dates- May 2019
Please select which dates you would like to book. If you do not require a certain day please leave blank. Please note:
All day= 8am-6pm
Tuesday 28th May 2019
Wednesday 29th May 2019
Thursday 30th May 2019
Friday 31st May 2019
Cost and payment
Please select the correct drop-down box/boxes that are appropriate to your booking.
IF YOU DO NOT COMPLETE THIS PART OF THE FORM
WILL NOT BE DIRECTED TO THE PAYMENT PAGE
- Applicable to University staff and students only. Offer expires on Sunday 28th April 2019.
- Applicable to external members and University members (after 28th April) who have paid full price for their first child. The sibling sessions cannot exceed the original booking but can be used for multiple siblings.
1 day - £41
2 days - £82
3 days- £123
4 days- £164
1 half day - £27
2 half days - £54
3 half days - £81
4 half days- £108
Full session- Sibling discount/ University discount
1 day - £36
2 days - £72
3 days - £108
4 days - £144
Half session- sibling discount/ University discount
1 half day- £23
2 half days- £46
3 half day- £69
4 half days-£92
Total transaction value:
Once you click ‘Make booking’ you will not be permitted to make any amendments to your booking and you will be directed to the University’s online payments system. Please have your card details ready. Your booking will not be valid until the full payment is received. If you have any difficulties using this form, please email:
Information about legal contact that we should be made aware of.
Please list one person who has parental responsibility for this child.
If applicable, please list the second person who has parental responsibility for this child.
Other than yourself, whom do you give permission to collect your child and to be contacted in an emergency on your behalf
First authorised person (must be 16+)
Relationship to child
Second authorised person (must be 16+)
Relationship to child
Please read the
Photography and Video consent form
and inform us of your decision
I have read and
to the Photography and Video terms and conditions
I have read and
agree to the Photography and Video terms and conditions
Before making your booking, please read the
Holiday Scheme Terms and Conditions
I have read and agree to the Holiday Scheme Terms and Conditions
Before booking, please read the statement below on emergency care
In the event of an emergency I give permission for Warwick Holiday Scheme staff to authorise medical treatment to my child on my behalf. I understand that such action would only be taken if I was unable to be contacted.
Before booking, please read the
Code of Conduct
I have read and understood the Holiday Scheme Code of Conduct
How did you hear about us?
If other, please describe.
Once you click ‘Make booking’ you will not be permitted to make any amendments to your booking. If you have any difficulties using this form, please email:
indicates a required field
The University of Warwick will process your personal data as captured within this registration form for the purpose(s) of registering your child for the University of Warwick’s Holiday Scheme services. Your personal data will not be shared or disclosed to any third parties external to the University of Warwick. Your personal data will not be transferred outside of the EEA, will be kept securely by the University of Warwick and will be retained until your child’s 15th birthday. You do however have the right to request that we remove your data at any point. If this is your intention please email firstname.lastname@example.org. The University of Warwick is the Data Controller of this information and is committed to protecting the rights of individuals in line with Data Protection Legislation. Please visit the University’s Data Protection web pages https://warwick.ac.uk/services/idc/dataprotection/ for further information in relation to your rights and how the University processes your personal data. The University’s Data Protection Officer, A Bajaj, can be contacted through: email@example.com">firstname.lastname@example.org and any requests or complaints should be made in writing to the University’s Data Protection Officer.