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Worsbrough Common Primary School and Rising Stars Children’s Centre Headteacher: Kate Davies Tel 01226289989

Rising Stars Children Centre Tel 01226320513 Bruce Avenue Barnsley S704EB Email: k.davies2@barnsley.org Website: http://worsbroughcblogs.net/

DAYCARE Children’s holiday form

Childs name: ____________________________________________________ Last day in daycare will be: ________________________________________ First day back in daycare will be: ____________________________________ Total days used: __________________________________________________ Parent/Carer signature: ____________________________________________ Staff signature: ___________________________________________________


Holiday Request Form