Form

First name*

Last name*

Email*

Child Full Name*

Child Date of Birth*

Day/Month/Year

Location of Interest*

Service of Interest*

Tax Free Childcare - Payment Reference

This code will help us identify your child in the payments we receive from HMRC to reconcile against your account so please check that it is the same as the payment reference

Tax Free Childcare Code*

Please provide us with the Tax Free Childcare code that would have been issued to you when you created your tax free childcare account. We can use this code to search for your child on the HMRC interface

Tax Free Childcare Amount*

Please advise how much you intend to be paying in via Tax Free Childcare each month. Note that this amount will be credited against the invoices raised on your account, and will stand as a liability for you to repay if we do not receive these funds from your Tax Free Childcare account

Tax Free Childcare Start Date

Please advise when you would like the tax free childcare payments to initiate so we can update the invoices accordingly. Please note, this will be affected, at the earliest, 4 weeks from the submission of this form

Day/Month/Year

Tax Free Childcare End Date

If you're aware of when you will expire your tax free childcare benefits (capped at £2000 / year), please advise when you expect to return to paying the fees in full directly yourself

Day/Month/Year

Payment Terms Compliance*

I confirm that I have set up the above payment to be issued to Hatching Dragons on the 1st of each month to pay for the childcare period one month ahead, in line with the school's payment terms and acknowledge that if these funds are not secured, the administrative surcharge of £25 will be applied against the account in line with the late fees policy and the companies terms and conditions

Yes