CHILD 2 / TIFEL / TIFLA 2

Surname / Kunjom : Name / Isem : ID No. / Nru. ID: Date of birth / Data tat-twelid: Age / Eta` Languages / Lingwa/i Child lives with / It-tifel/tifla j/tgix ma : Parent / enitur 1 Parent / enitur 2 Both / It-tnejn

Allergies / Alleriji Medical Condition / Kundizzjoni Medika Disability / Diabbilt Special circumstances / irkustanzi Spejali

Specify / Speifika: Specify / Speifika: Specify / Speifika: Specify / Speifika:

None / Xejn None / Xejn None / Xejn None / Xejn

2013

PARENT / GUARDIAN / ENITUR / MIN JIEU SIEB IT-TFAL First Name(s) / Isem Last Name / Kunjom Mobile / Mowbajl Home Phone / Numru tat-Telefon tad-Dar Email / Imejl Address / Indirizz Parent I.D. No./ Numru tal-ID tal-enitur Relationship to child / Xtii mit-tifel jew tifla? CUSTODY ACCESS / AESS GALL-KUSTODJA Names of those who have custody / Isem ta min gandu l-kustodja: Is there a court order in place / Hemm court order attwat?: Yes / Iva No / Le. If YES, please speak to Centre Co-ordinator / Jekk IVA, kellem lill-koordinatur ta-entru.

EMERGENCY CONTACT DETAILS 1 / DETTALJI TA PERSUNA 1 FKA TEMERENZA Surname / Kunjom : Name / Isem : I.D. No / Numru tal-ID: Mobile / Mowbajl : Tel (home / dar): Tel (work / xogol): Address / Indirizz : Relationship / Relazzjoni EMERGENCY CONTACT DETAILS 2 / DETTALJI TA PERSUNA 2 FKA TEMERENZA Surname / Kunjom : Name / Isem : I.D. No / Numru tal-ID: Mobile / Mowbajl : Tel (home / dar): Tel (work / xogol): Address / Indirizz : Relationship / Relazzjoni Booking is confirmed once payment is effected. Payment is to be received when registering for the service. L-applikazzjoni tii kkonfermata meta jsir il-las. Il-las gandu jsir meta tirreistra gas-servizz. Tax Rebate Please fill accordingly / Jekk jogbok imla kif xieraq Passing my details to the Inland Revenue Department for the purpose of benefitting from any tax concessions offered, should this information be requested. Jekk din l-informazzjoni tii mitluba, ngaddu d-dettalji tiegek lid-Dipartiment tat-Taxxi Interni gall-finijiet ta benefiji jew kwalunkwe konessjonijiet ta taxxa li jiu offruti. Yes/Iva No/Le If yes, specify name of claimant (parent): ________________________________________ ID. No. ______________________ Jekk iva, speifika l-isem ta min se jkun qed jagmel it-talba (enitur)
Documents that need to be presented with this form / Dokumenti li gandhom jiu ppreentati ma din il-formola Copy of ID card of parent / guardian / Kopja tal-Karta tal-Identit tal-enitur/i jew min jieu sieb it-tfal Copy of ID Card of person authorised to collect the child / ren from Klabb 3-16 Centre / Kopja tal-Karta tal-Identit ta kull min jista jibor it-tfal mi-entru CDAU report (where applicable) / Rapport tas-CDAU (fejn applikabbli) Legal Documents regarding Guardianship and/or Custody (where applicable) / Dokumenti tal-Kustodja (fejn applikabbli) Original Birth Certificates / ertifikati/i tat-Twelid Oriinali For Office Use Only

Welcome to Klabb 3-16 Sajf! Merba fi Klabb 3-16 Sajf!

The Foundation for Educational Services (FES) welcomes you to Klabb 3-16 Sajf! Klabb 3-16 Sajf is a summer programme of fun and educational activities for children aged between 3 and 16 years. The service provides a safe, stimulating and child-friendly environment with appropriate adult supervision during the summer holidays. Parents can choose to use Klabb 3-16 Sajf during the morning, until 1.15 pm, or for a full day, as well as choose to make use of the service 3, 4, 5 days a week. Klabb 3-16 Sajf is part of FES after-school care service Klabb 3-16 which runs throughout the year, from Monday to Friday between 2.30 pm and 6.00 pm. The service provides care during out of school hours and school holidays where needed. There is a planned programme of activities on offer where children do their homework and/or take part in educational fun activities. Klabb 3-16 caters for children who attend State, Church and Independent Schools. Klabb 3-16 service is offered from 23 localities. For more information about Klabb 3-16, contact us at klabb316.mede@gov.mt or 22586818 or visit our Facebook page. Il-Fondazzjoni gall-Servizzi Edukattivi (FES) tilqak gal darb ora fi Klabb 3-16 Sajf! Klabb 3-16 Sajf huwa programm tas-sajf battivitajiet edukattivi u divertenti gal tfal ta bejn it-3 u s-16-il sena. Is-servizz jipprovdi ambjent sikur u stimulanti bsupervijoni xierqa, matul il-vaganzi tas-sajf. Il-enituri jistgu jaglu li juaw Klabb 3-16 matul in-nofs ta nhar ta filgodu jew gal urnata sia kif ukoll jistgu jaglu li jagmlu uu mis-servizz 3, 4 jew 5 ijiem fil-imga. Klabb 3-16 Sajf huwa parti minn Klabb 3-16, servizz ta wara l-in l-iskola li toffri l-FES matul is-sena kollha, mit-Tnejn sal-imga bejn is-2.30 pm u s-6.00 pm. Is-servizz jipprovdi kura u arsien fis-sigat ta wara l-in tal-iskola jew ranet ta vaganzi. Hemm programm ippjanat tattivitajiet fejn it-tfal jistgu jlestu l-homework u/jew jiedu sehem fattivitajiet edukattivi u divertenti. Klabb 3-16 huwa servizz gat-tfal li jattendu skejjel talGvern, tal-Knisja u Indipendenti. Is-servizz ta Klabb 3-16 jii offrut minn 23 lokalitajiet. Gal aktar informazzjoni dwar Klabb 3-16, ikkuntattjana fuq klabb316.mede@gov.mt jew 22586818 jew ur il-pana tal-Facebook.

Reference No.: Registration Date Receipt of Payment - Receipt No.: Paid by: Cheque Cash:

Cheque No.: Amount paid:

FES Official Signature:_________________________

In the case where there are Custody and Care arrangements, the original birth certificate needs to be presented to confirm the details / Fka li hemm arranamenti ta Kura u Kustodja, gandu jii ppreentat i-ertifikat tat-Twelid oriinali tat-tfal biex nikkonfermaw id-dettalji. (I-ertifikat jingata lura u ma jinammx).

For further information, please use the following / Gall-aktar informazzjoni kkuntattjana hawn: 22586818 / 22586825/6 klabb316.mede@gov.mt

Summer dates / Dati tas-Sajf: Programme Break / Waqfa tas-servizz: Opening hours /Sigat ta ftu:

15th July 13th September 2013 (8 weeks) Mill- 15 ta Lulju sat-13 ta Settembru 2013 (8 imgat) 12 16 August 2013 /12 16 tAwissu 2013 From Monday to Friday / Mit-Tnejn sal-imga 7.15am 5.15pm

Who can attend and when? / Min jista jattendi u meta?

The Reading-Writing activity will be organised over a series of six 2-hour sessions at the following centres: L-attivita ta Qari u Kitba ser tii organizzata gal sitt sessjonijiet, ta sagtejn kull darba, fdawn i-entri: Victoria, Melliea, Siiewi, BKara, Pembroke, Qormi, BBugia, abbar, Fgura This activity is open to children attending Klabb 3-16 centres who have just finished Year 3 through to Form 2. Dil-attivita hija miftua gal tfal li qegdin jattendu Klabb 3-16 u li gadhom kemm spiaw il-Year 3 sa tfal li gadhom kemm spiaw il-Form 2. This activity is offered on a first come, first served basis. / Jiu aettati l-ewwel applikazzjonijiet li nirievu.

Payment / las: 10

REGISTRATION AND PAYMENT / REISTRAZZJONI U LAS

Registration Days / ranet tar-reistrazzjoni (Gozo): Thursday 6th June, Tuesday 18th June, Wednesday 19th June Venue / Post (Malta): ex-Umberto Colosso School, St Joseph High Road, St. Venera Venue / Post (Gozo): Gozo College, Rabat Primary School, Triq Vajringa, Victoria Time / in (Malta and Gozo): 8.30 am - 11.30 am and / u 1.00 pm - 6.00 pm

Registration Days / ranet tar-reistrazzjoni (Malta): Monday 10th - Friday 14th June

Summer Programme / Programm tas-Sajf

Number of days a week / Numru ta ranet fil-imga:

Select one from each option / Gael wada minn kull gala

3 days / 3 ranet 4 days / 4 ranet 5 days / 5 ranet

Days / ranet: 1. _____________ 2. _____________ 3. _____________ 4. _____________ At what time? / Fi xin gandek bonn is-servizz? _____________ - ________________ Specify extra hours (e.g. 1.15 3.15): _______________am/pm ______________am/pm Tick your Bundle of choice / Gael l-offerta li tippreferi: 3- DAY BUNDLE / OFFERTA 3 IJIEM 4 weeks 75 8 weeks 150

Centre / entru Choose one of the following / Agel wieed minn dawn
Klabb 3-16 St Pauls Bay Primary School 21573495 Klabb 3-16 Mosta Primary School A 21585070 Klabb 3-16 Rabat Primary School 21452306 Klabb 3-16 amrun Primary School (ue Pace) 21235301 Klabb 3-16 Fgura Primary School A 21665692 Klabb 3-16 Victoria Primary School 21558057 Klabb 3-16 Mellieha Primary School 21573495 Klabb 3-16 BKara Primary School A 21493459 Klabb 3-16 ebbug Primary School 21461736 Klabb 3-16 urrieq Primary School 21650789 Klabb 3-16 ejtun Primary School A 21665692 Klabb 3-16 Nadur Primary School 21558057 Klabb 3-16 Pembroke Primary School 27207031/2 Klabb 3-16 Attard Primary School 21410350 Klabb 3-16 Siggiewi Primary School 21460938 Klabb 3-16 Luqa Primary School 21653221 Klabb 3-16 MScala Primary School 21632001 Klabb 3-16 Xagra Primary School 21558057 Klabb 3-16 San wann Primary School A 21385223 Klabb 3-16 Naxxar Primary School 21423550 Klabb 3-16 Qormi Primary School (San or) 21443161 Klabb 3-16 BBugia Primary School 21653221 Klabb 3-16 abbar Primary School A 21663203

Siblings / Awa 72 Siblings / Awa 92 Siblings / Awa 110

Siblings / Awa 144 Siblings / Awa 184 Siblings / Awa 220

4-DAY BUNDLE / OFFERTA 4 IJIEM 4 weeks 96 8 weeks 192

5-DAY BUNDLE / OFFERTA 5 IJIEM 4 weeks 115 8 weeks 230

Extra Hours +10 hours 12 +40 hours 48

+20 hours +50 hours

24 60

+30 hours 36 +__ hours ____

For office use only / Gall-uu tal-Uffiju biss

(Child 1 Bundle _____) + (Siblings Bundles __ x ____) + (Extra hours ____) = Total ______
The above fees cover the daily activities conducted at the Klabb 3-16 Centre. Additional costs due to outings and the organisation of special events / activities will be charged ad hoc. Participation will be optional. Il-las indikat hawn fuq ikopri l-attivitajiet li jiu organizzati fi-entru ta Klabb 3-16. las addizzjonali gall-ariet jew attivitajiet/avvenimenti spejali jii arjat separatament. Mhux obbligatorju li tieu sehem fdawn il-ariet jew avvenimenti.

During School Days call between 2.30 and 6.00 pm. / Fil-ranet tal-iskola empel bejn is-2.30 u s-6.00 ta filgaxija.

Childrens details / Dettalji tat-tfal

CHILD 1 / TIFEL / TIFLA 1 Surname / Kunjom : Name / Isem : ID No. / Nru. ID: Date of birth / Data tat-twelid: Age / Eta` Languages / Lingwa/i Child lives with / It-tifel/tifla j/tgix ma : Parent / enitur 1 Parent / enitur 2 Both / It-tnejn

Activities / Attivitajiet
Activities include: Cooking for fun, physical activities, creative play (arts, crafts, etc.), Storytelling and reading activities, water games and others. L-attivitajiet jinkludu: Tisjir gall-gost, attivitajiet fisii, logob kreattiv (arti, krafts, e.), qari ta stejjer u attivitajiet ta qari, logob bl-ilma u orajn.

Allergies / Alleriji Medical Condition / Kundizzjoni Medika Disability / Diabbilt Special circumstances / irkustanzi Spejali

Specify / Speifika: Specify / Speifika: Specify / Speifika: Specify / Speifika:

Reading-Writing for Fun! / Attivita ta Qari u Kitba gall-Gost!

The Reading-Writing activity explores writing in a fun and relaxed setting. Tutors will guide children to explore and develop reading and writing strategies through a creative approach. Matul l-attivita ta Qari u Kitba t-tfal jesploraw l-kitba bmod pjaevoli u fambjent rilassanti. It-tutors ser jiggwidaw lit-tfal biex jiskopru u jiiluppaw iliet tal-qari u l-kitba li jwassluhom gal proess kreattiv.

None / Xejn None / Xejn None / Xejn None / Xejn

PARENT / GUARDIAN / ENITUR / MIN JIEU SIEB IT-TFAL First Name(s) / Isem Last Name / Kunjom Mobile / Mowbajl Home Phone / Numru tat-Telefon tad-Dar Email / Imejl Address / Indirizz Parent I.D. No./ Numru tal-ID tal-enitur Relationship to child / Xtii mit-tifel jew tifla?