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2022-08-30-accounts

Horseshoe Communlty Pre School Trustees, annual report for the yoar ended 30 August 2022 R•glst•rod namo Horseshoe Community Playgrnup R•gl$t•rnd charlty number 1029396 Maln addrè Banstead Youth Centre. The Horseshoe. Banstead. SM7 2BQ Commltt•e mom￿rn Mrs Laura Holden & Francesca Buuer Ms Louise Br¢)oks MS Lauren Myring Ms Cady Morris Ms Erin Lonsd8le M$ Samantha Emery MS Katie Barwick Joint Chair T￿aSurer Secretsry c￿nmIttee Member C¢)mmittee Member C¢ynmrttee Member Commfftee PAember Gov•manco and management The pre-$ehool is managed under the ￿n$b￿jtron adopted 14th November 1977. as amended 25b) ju￿ 2014. Committee members are appointed on an annual basis. Committe8 members are votsd in during the Annual General Meeting. There are monthty Committee meetings durtng which matters whlch requlre the attention ol the committee are discussed aThJ agreed upon. Minutes of each meeting are written up aThl arvjlated. Alms and obJ•ctlves To enhance the development arKI education of chIld￿n under 8tstutOry 8¢hool age. by encouraging parents to understand and provide for the r￿ed$ ol their children through community groups. Summary of the maln achlevements durlThg the p•rlod The pre-school and the children have had another difficult year. due lo Covid. We remained open throughout the year. however, daily child numbers were lower due to the seeond lockdown. From April, all chIld￿n retLtmed and new children started. The rest of the academic year. we increased in child numbers. t>Jring the year. we raised arouThl £1.500 through varioLts sponsored events. Christmas and Easter hamper raffles and a couple of smaller events. We currenuy have 28 th￿ldren on the register and plaees available next lern. Our waitsng Iisl is open to all children and enty is based on Surrey County Council's schools admission policy.

We continue to be involved in the lexal wnmunty, *Ylh strong links to ts wim8ry schools next door. invite the local cnmmunity lo our major events, includiThJ cake sale$, Ihe Christmas Bazaar and May Fayre. The thildren do sponsored events,. the event indudes the support and help of the local community lo rèise funds to benefit Ihe pre-school thildren of Banslead by providing a much needed arxl uged setting. Tho charlty'• pollcy on rnserv At the end ol the year, we had £5.946 in our bank aceounts. 01 Ihis, £4.698 was in the fundraisiThJ pol, which is held spectfically to spend on items to benefit ihe thikJren {for example. equipment, entertainmenl. outs.ngs and oeeasionally fees lor families who are struggling to payl. Unfortunately, at the end of the year, we had to borrow £1.000 from the tundraising account in order to pay the bills. Vrfe 8im lo pul this bock into fUr￿raising pot as soon as we can. Our aim is to hold al least £6,000 in the bank accounts as a contingenw. The past year was difficult tecause we had some unexpected lax and penS￿n bills. 80 the contingenry 1$ ¢urrentty less than we W￿kj like. However, we expect the finances to improve again over the ¢oming year, so 7MII aim to increase the conts"ngency once again. Futur• Pla We will continue to ralse fund8 to provmle ￿rIher equipmont and opporlunilies for tho pre-school ¢hildren of the Banstead Community. Signed on behall ofth? tharlty's trustees: Ello Date 2z16123 Name.. Laura AO(oCe/). Positson.. Chair Signed Date Name.. Posit￿." Chair

INCOME 2021/22 Total FEET 3&4 Yr Funding EYPP
September
SurreyCC 800.00 800.00
SurreyCC 6,117.12 6,117.12
Fees - Marnie 112.00
Fees -Joshua 133.00
SurreyCC 291.00 291.00
Fees - Henry 329.00
Fees - 350.00
Fees - Noah 269.50
SurreyCC 800.00 800.00
Fees - Max 493.50
Fees 53.00
fees - alex 35.00
fees - Zac 164.50
fees - Harley 87.50
Fees - Ellis-George 387.00
Fees - Ivy 216.50
Fees - Cash 269.50
Fees - Cash 145.50
Fees - Ever 329.00
Month Totals 11,382.62 - 8,008.12 -
October
Fees - Harley 70.50
Fees - Amber 80.00
SurreyCC 7,887.36 7,887.36
Fees - Scarlett 150.00
Fees - Ellis-George 382.00
-
-
-
Month Totals 8,569.86 - 7,887.36 -
November
Fees - Zachary 164.50
Fees - Ellis-George 358.50
Fees - Ivy 174.00
Fees -Josh 282.00
Fees - Henry 282.00
Fees - Bertie 165.50
Fees - Harley 216.00
Fees - Isla - Cash 300.00
Fees - Alicia - Cash 80.00
-
-
-
-
Month Totals 2,022.50 - - -
December
Fees - Noah 158.50
Fees - Ruby 357.00
Fees - Marnie 102.00
Fees - Scarlett 117.00
Fees - Marlowe 282.00
Fees - Nilah 435.50
Fees - Zachary 141.00
Fees - Amara 90.50
Fees - Ellis-George 382.00
-
Month Totals 2,065.50 - - -
January
-
Fees - Zachary 141.00
Fees - Coco 30.00
Fees - Ellis-George 382.00
Fees -Josh 235.00
Fees - Bella 37.50
Fees - Max 122.50
Fees - Ruby 385.00
Fees - Harley 90.00
Fees - Harley 90.00
Fees - Henry 270.00
Fees - Ivy 145.00
Fees - Marlowe 265.50
-
-
-
-
-
-
Month Totals 2,193.50 - - -
February
-
Fees - Scarlett 95.00
Fees - Robyn 117.50
Fees - Ellis-George 382.00
Fees - Zachary 50.00
-
-
-
-
-
-
-
Month Totals 644.50 - - -
March
-
Fees - Marnie 118.50
Fees -Josh 258.50
Fees - Coco 37.50
Fees - Amara 223.50
Fees - Marlowe 155.50
Fees - Amber 195.00
Fees - Bertie 136.50
Fees - Max 733.12
Fees - Isla 276.00
Fees - Cyrus 72.00
Fees - Noah 157.50
Fees - Marlowe 258.50
Fees - Scarlett 89.00
Fees - Henry 300.50
Fees - Harley 85.00
Fees - Harley 85.00
Fees - Noah 131.00
Fees - Zachary 47.50
Fees - Ruby 258.00
Fees - Ivy 145.00
Fees - Ellis-George 288.00
Fees - Coco 35.00
Fees - Sienna 70.50
Fees - Ellis Cash 62.50
Fees - Alicia Cash 80.00
-
Month Totals 4,299.12 - - -
April
-
Fees - Robyn 437.50
Fees - Alex 55.00
Fees - Amara 224.00
Fees - Ellis-George 100.00
Fees - Alicia Cash 72.50
Fees - Alicia Cash 114.00
-
-
-
-
-
Month Totals 1,003.00 - - -
May
-
Fees - RubyR 238.50
Fees - Ivy 156.00
Fees - Marnie 140.00
Fees - Marlowe 235.00
Fees - Reggie 254.50
Fees - Henry 300.50
Fees - Arthur 282.00
Fees - Marlowe/Nilah 189.00
Fees - RubyP 336.00
Fees - Harley 218.00
Fees - Noah 117.50
Fees - Sienna 40.00
Fees -Josh 30.00
Fees - zachary 112.00
Fees - Robyn 153.00
Fees - Isla 281.00
Fees - Sienna 19.99
Fees - Coco Cash 70.00
3,172.99 - - -
June
-
Fees - Ellis Cash 75.00
Fees - Alicia Cash 141.00
-
-
-
Discretionary Deprevation Inclusion/daf Fees Donations Interest
112.00
133.00
329.00
350.00
269.50
493.50
53.00
35.00
164.50
87.50
387.00
216.50
269.50
145.50
329.00
- - - 3374.50 - -
70.50
80.00
150.00
382.00
- - - 682.50 - 0.00
164.50
358.50
174.00
282.00
282.00
165.50
216.00
300.00
80.00
- - - 2,022.50 - -
158.50
357.00
102.00
117.00
282.00
435.50
141.00
90.50
382.00
- - - 2065.50 0.00 0.00
141.00
30.00
382.00
235.00
37.50
122.50
385.00
90.00
90.00
270.00
145.00
265.50
- - - 2,193.50 - -
95.00
117.50
382.00
50.00
- - - 644.50 - -
118.50
258.50
37.50
223.50
155.50
195.00
136.50
733.12
276.00
72.00
157.50
258.50
89.00
300.50
85.00

85.00 131.00 47.50 258.00 145.00 288.00 35.00 70.50 62.50 80.00 - - - 4,299.12 - - 437.50 55.00 224.00 100.00 72.50 114.00 - - - 1,003.00 - - 238.50 156.00 140.00 235.00 254.50 300.50 282.00 189.00 336.00 218.00 117.50 40.00 30.00 112.00 153.00 281.00 19.99 70.00 - - - 3,172.99 - - 75.00 141.00

- - - 216.00 - -
- - - 0.00 - 0.00
- - - 0.00 - 0.00
- - - 19,674.11 - -

Money in from Fundraising Sundries - - 11,382.62 - - 8,569.86 - - 2,022.50

0.00 0.00 2,065.50 24,040.48
- - 2,193.50
- - 644.50

THE HORSESHOE COMMUNITY PRE-SCHOOL

MAIN ACCOUNT

RECEIPTS AND PAYMENTS As at 13/06/22

31 AUGUST 2021 - 30 AUGUST 2022

Opening balance

Receipts
Fees
FEET
3&4 Yr Funding
Ext Funding 30 hours
Early Years Pupil Premium EYPP
Early Intervention Funding EIF
Deprevation Funding
Disability Access Funding DAF
Donations
Interest
Payments
Stationery
Rent
Staf training
Wages
Tax/NI
Equipment
Petty Cash
Insurance
Ofsted Registration
Tea/Cofee
Snack
Disposables
Arts/Crafts
Sundries
Administration
Bank charges
Books
Phone
Cleaning Equipment
Advertising/Website
Topics
Recruitment Cost
Closing balance
21,678.00
11,009.06
33,826.41
5,573.01
824.79
2,691.00
3,532.17
615.00
-
-
396.69
7,437.37
711.05
49,924.04
144.00
489.33
-
725.89
50.00
8.99
339.33
103.48
189.64
278.07
-
12.00
48.40
30.00
2.35
185.82
-
-
79,749.44
61,076.45
18,672.99

Closing balance

Name Chqno Stationery Rent Staf Train Wages Tax/NI
September
Rent 892.40 892.40
Rent 817.20 817.20
Bank 6.00
Refund Anna 5.84 3.99
Refund Carol 36.98
Refund Kerry 108.52
Sienna Broderick 489.54 489.54
Lisa Brooks 513.22 513.22
Carol Clisby 1,098.98 1,098.98
Rachel Head 921.64 921.64
Lisa Hunt 507.64 507.64
Toni Marshall 590.41 590.41
KerryO'Neill 941.49 941.49
Anna Scott 591.52 591.52
Refund Kerry 88.10 88.10
0.00
Monthly Total 7,609.48 92.09 1,709.60 0.00 5,654.44 0.00
October
rent 481.05 481.05
fndel 83.49
ofsted 50.00
bank 6.00
Sienna Broderick 640.42 640.42
Lisa Brooks 498.94 498.94
Carol Clisby 1,031.10 1,031.10
Rachel Head 939.23 939.23
Lisa Hunt 507.64 507.64
Toni Marshall 590.41 590.41
KerryO'Neill 952.41 952.41
Anna Scott 534.40 534.40
0.00
0.00
0.00
0.00
Monthly Total 6,315.09 0.00 0.00 481.05 5,694.55 0.00
November
refund Carol 10.84
refund Kerry 144.89 18.00
School Vouchers -75.00
refund anna 4.10
refund carol 26.99
refund Kerry 136.94
bank 0.00
Sienna Broderick 0.00
Lisa Brooks 0.00
Carol Clisby 0.00
Rachel Head 0.00
Lisa Hunt 0.00
Toni Marshall 0.00
KerryO'Neill 0.00
Anna Scott 0.00
refund Kerry 185.82
0.00
0.00
Monthly Total 434.58 18.00 0.00 0.00 0.00 0.00
December
Sienna Broderick 489.54 489.54
Lisa Brooks 749.43 749.43
Carol Clisby 1,006.80 1,006.80
Equipment Pettycash Insurance Registration Tea/cofee Snack Disposable arts/crafts Sundries
1.85
26.99 9.99
69.59 19.57 19.36
96.58 0.00 0.00 0.00 0.00 21.42 29.35 0.00 0.00
83.49
50.00
83.49 0.00 0.00 50.00 0.00 0.00 0.00 0.00 0.00
5.37 5.47
6.36 45.53 75.00
-75.00
4.10
26.99
44.96 52.83 9.40
78.31 0.00 0.00 0.00 0.00 107.83 0.00 9.40 5.47
Administration Bank Charges Books Phone CleaningE Advertising Theme Recruitment
6.00
0.00 6.00 0.00 0.00 0.00 0.00 0.00 0.00
6.00
0.00 6.00 0.00 0.00 0.00 0.00 0.00 0.00
29.75
185.82
0.00 0.00 29.75 0.00 0.00 185.82 0.00 0.00
Moneyout(in from fundraising)
0.00 7,609.48
0.00 6,315.09
0.00
Name Chqno Stationery Rent Staf Train Wages Tax/NI
Rachel Head 921.64 921.64
Lisa Hunt 507.64 507.64
Toni Marshall 619.56 619.56
KerryO'Neill 1,052.47 1,052.47
Anna Scott 560.78 560.78
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Monthly Total 5,907.86 0.00 0.00 0.00 5,907.86 0.00
January
Sienna Broderick 505.80 505.80
Lisa Brooks 611.16 611.16
Carol Clisby 1,064.01 1,064.01
Rachel Head 973.37 973.37
Lisa Hunt 597.51 597.51
Toni Marshall 619.56 619.56
KerryO'Neill 1,159.29 1,159.29
AmyWilliams 787.49 787.49
Hope Education 47.42
Refund Carol 31.97 21.98
Refund Kerry 180.00
School Vouchers -180.00
Refund Kerry 52.03 22.00
Refund Carol 21.33
Monthly Total 6,470.94 43.98 0.00 0.00 6,318.19 0.00
February
Sienna Broderick 473.00 473.00
Lisa Brooks 235.14 235.14
Carol Clisby 1,064.01 1,064.01
Rachel Head 857.79 857.79
Lisa Hunt 597.51 597.51
Toni Marshall 619.56 619.56
KerryO'Neill 1,141.68 1,141.68
AmyWilliams 787.49 787.49
Refund Kerry 6.16
Refund Kerry 5.94
Refund Kerry 6.55
Refund Kerry 8.00
Refund Kerry 48.03
Refund Kerry 24.00
Refund Kerry 180.00
School Vouchers -180.00
Refund Kerry 12.23
Refund Kerry 6.17 4.25
Refund Kerry 115.00 115.00
Refund Kerry 52.65 52.65
Refund Carol 5.97
Refund Carol 1.50
Refund Carol 19.99
Rent 1,001.52 1,001.52
Rent 1,130.04 1,130.04
Rent 426.79 426.79

Equipment Petty cash Insurance Registration Tea/coffee Snack Disposable arts/crafts Sundries

Equipment Pettycash Insurance Registration Tea/cofee Snack Disposable arts/crafts Sundries
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
47.42
9.99
180.00
-180.00
30.03
14.98 6.35
0.00 0.00 0.00 0.00 0.00 30.03 9.99 47.42 0.00
8.00
48.03
24.00
180.00
-180.00
12.23
1.92
5.97
1.50
19.99
Administration Bank Charges Books Phone CleaningE Advertising Theme Recruitment
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.16
5.94
6.55

Money out lin from fundraising) 0.00 0.00

Name Chqno Stationery Rent Staf Train Wages Tax/NI
0.00
Monthly Total 8,646.72 56.90 2,558.35 115.00 5,776.18 0.00
March
Sienna Broderick 473.00 473.00
Carol Clisby 1,064.01 1,064.01
Eileen Gregoire 1,230.52 1,230.52
Rachel Head 973.37 973.37
Lisa Hunt 597.51 597.51
Toni Marshall 679.50 679.50
KerryO'Neill 1,141.68 1,141.68
AmyWilliams 787.49 787.49
Rent 1,214.91 1,214.91
Rent 620.79 620.79
Rent 824.48 824.48
Refund Kerry 68.87
Refund Carol 7.42
Refund Kerry 176.15 55.75
Payroo 18.00 18.00
Payroo 18.00 18.00
Payroo 18.00 18.00
Payroo 18.00 18.00
Payroo 18.00 18.00
Payroo 18.00 18.00
Payroo 18.00 18.00
Payroo 18.00 18.00
Refund Kerry 45.62 27.54
Refund Carol 60.54
Refund Rachel 11.99
TTS 54.59
Hope 13.13
Refund Kerry 30.00
Refund Carol 19.98
Refund Carol 5.22
Refund Carol 1.69 1.69
0.00
Monthly Total 10,246.46 84.98 2,660.18 0.00 6,947.08 144.00
April
Sienna Broderick 363.80 363.80
Carol Clisby 1,105.58 1,105.58
Eileen Gergoire 974.31 974.31
Rachel Head 1,021.18 1,021.18
Lisa Hunt 637.08 637.08
Toni Marshall 794.39 794.39
KerryO'Neill 1,160.93 1,160.93
AmyWilliams 787.49 787.49
Refund Kerry 97.11
Refund Carol 5.94
Refund Kerry 323.32 28.19
SurreyCredit Control 46.27
Early years alliance 115.00 115.00
0.00
Monthly Total 7,432.40 28.19 0.00 115.00 6,844.76 0.00
May
0.00
Carol Clisby 1,059.62 1,059.62
Elaine Dartnell 969.55 969.55

Equipment Petty cash Insurance Registration Tea/coffee Snack Disposable arts/crafts Sundries

Equipment Pettycash Insurance Registration Tea/cofee Snack Disposable arts/crafts Sundries
107.49 0.00 0.00 0.00 0.00 14.15 0.00 0.00 0.00
27.80 12.46 28.61
5.07
73.74 4.99 28.97 5.99 6.71
4.00 4.00 9.08 1.00
12.95 19.98 27.61
11.99
54.59
13.13
19.98
5.22
105.54 0.00 0.00 0.00 8.99 73.75 57.94 104.04 27.61
5.94
17.92 36.16 240.00
17.92 0.00 0.00 0.00 0.00 42.10 0.00 0.00 240.00
Administration Bank Charges Books Phone CleaningE Advertising Theme Recruitment
0.00 0.00 18.65 0.00 0.00 0.00 0.00 0.00
2.35
30.00
0.00 0.00 0.00 30.00 2.35 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Money out (in from fundraising)

0.00 0.00 97.11 97.11

Name Chqno Stationery Rent Staf Train Wages Tax/NI
Eileen Gregoire 955.20 955.20
Rachel Head 964.27 964.27
Lisa Hunt 843.73 843.73
KerryO'Neill 1,191.13 1,191.13
AmyWilliams 797.48 797.48
Rent 509.24 509.24
AmyRefund 15.04
Carol Refund 15.50
KerryRefund 132.01 72.55
Morton Michel 725.89
0.00
Monthly Total 8,178.66 72.55 509.24 0.00 6,780.98 0.00
June
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Monthly Total 0.00 0.00 0.00 0.00 0.00 0.00
July
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Monthly Total 0.00 0.00 0.00 0.00 0.00 0.00
August
Equipment Pettycash Insurance Registration Tea/cofee Snack Disposable arts/crafts Sundries
3.85 6.20 4.99
7.66 7.84
38.54 20.94
725.89
0.00 0.00 725.89 0.00 0.00 50.05 6.20 28.78 4.99
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Administration Bank Charges Books Phone CleaningE Advertising Theme Recruitment
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Money out lin from fundraising) 0.00 0.00 0.00

Name Chqno Stationery Rent Staf Train Wages Tax/NI
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Monthly Total 0.00 0.00 0.00 0.00 0.00 0.00
YTD Totals 61,242.19 396.69 7,437.37 711.05 49,924.04 144.00
61,173.56 50,068.04
Budget 68.63 100.00 9,800.00 500.00 40,714.00
Equipment Pettycash Insurance Registration Tea/cofee Snack Disposable arts/crafts Sundries
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
489.33 0.00 725.89 50.00 8.99 339.33 103.48 189.64 278.07
348.32
500.00 75.00 495.00 50.00 75.00 200.00 350.00 100.00
Administration Bank Charges Books Phone CleaningE Advertising Theme Recruitment
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 12.00 48.40 30.00 2.35 185.82 0.00 0.00
200.00 90.00 50.00 60.00 50.00 200.00 100.00 150.00

Money out lin from fundraising) 0.00 97.11

Horseshoe Community Pre School Trustees’ annual report for the year ended 30 August 2022

Registered name Horseshoe Community Playgroup

Registered charity number 1029396

Main address

Banstead Youth Centre, The Horseshoe, Banstead, SM7 2BQ

Committee members

Mrs Laura Holden & Francesca Butler Joint Chair Ms Louise Brooks Treasurer Ms Lauren Myring Secretary Ms Carly Morris Committee Member Ms Erin Lonsdale Committee Member Ms Samantha Emery Committee Member Ms Katie Barwick Committee Member Ms Shona Henry Committee Member Ms Charlotte Puddy Committee Member Ms Hannah Forrester-Charles Committee Member

Governance and management

The pre-school is managed under the constitution adopted 14th November 1977, as amended 25[th] June 2014.

Committee members are appointed on an annual basis. Committee members are voted in during the Annual General Meeting.

There are monthly committee meetings during which matters which require the attention of the committee are discussed and agreed upon. Minutes of each meeting are written up and circulated.

Aims and objectives

To enhance the development and education of children under statutory school age, by encouraging parents to understand and provide for the needs of their children through community groups.

Summary of the main achievements during the period

The pre-school and the children have had another difficult year, due to Covid. We remained open throughout the year, however, daily child numbers were lower due to the second lockdown. From April, all children returned and new children started. The rest of the academic year, we increased in child numbers. During the year, we raised around £1,500 through various sponsored events, Christmas and Easter hamper raffles and a couple of smaller events.

We currently have 28 children on the register and places available next term. Our waiting list is open to all children and entry is based on Surrey County Council’s schools admission policy.

We continue to be involved in the local community, with strong links to the primary schools next door. We invite the local community to our major events, including cake

sales, the Christmas Bazaar and May Fayre. The children do sponsored events; the event includes the support and help of the local community to raise funds to benefit the pre-school children of Banstead by providing a much needed and used setting.

The charity’s policy on reserves

At the end of the year, we had £5,946 in our bank accounts. Of this, £4,698 was in the fundraising pot, which is held specifically to spend on items to benefit the children (for example, equipment, entertainment, outings and occasionally fees for families who are struggling to pay). Unfortunately, at the end of the year, we had to borrow £1,000 from the fundraising account in order to pay the bills. We aim to put this back into the fundraising pot as soon as we can.

Our aim is to hold at least £6,000 in the bank accounts as a contingency. The past year was difficult because we had some unexpected tax and pension bills, so the contingency is currently less than we would like. However, we expect the finances to improve again over the coming year, so we will aim to increase the contingency once again.

Future Plans

We will continue to raise funds to provide further equipment and opportunities for the pre-school children of the Banstead Community.

Signed on behalf of the charity’s trustees:

Signed ______ Date _

Name:

Position: Chair

Signed ______ Date _

Name:

Position.. Chair