Booking

The Green Outdoors – Easter Club 2018

April 3rd – April 5th FULL
April 6th – April 13th

Cost £35.00 per day from 09:00-17:00
+ £2.50 drop off from 08:00 – 09:00
+ £2.50 collection from 17:00-18:00

Please pay on the day

Book your spaces below.

Name(required)

Address(required)

Email(required)

Phone Number(s)(required)

Child Name(required)

Child D.O.B(required)

Child Name (2)

Child D.O.B (2)

Child Name (3)

Child D.O.B (3)

Dates(required) Fri Apr 6th

Mon Apr 9th

Tues Apr 10th

Weds Apr 11th

Thurs Apr 12th

Fri April 13th

Hours(required) 8am to 5pm 9am to 5pm 8am to 6pm 9am to 6pm

Dietary Requirements

Medical Information/Any health restrictions or current treatment (please inc. asthma & hay fever)

Does your child have any allergies?

National Health Number

Doctor's Name & Address(required)

Emergency Contact Name(required)

Emergency Contact Telephone(required)

Emergency Contact Email

Questions/Comments

1. I give my permission for my child to participate fully in the Green Outdoors activities.(required)

2. I will inform the event leaders if my child has been in contact with any infectious diseases within four weeks prior to the event.(required)

3. I give my consent for my child to be given basic First Aid treatment by a member of the Leadership Team should an accident occur.(required)

4. If it becomes necessary for my child to receive medical treatment and I cannot be contacted by telephone or any other means to authorise this, I hereby give my general consent to any necessary medical treatment and authorise the Leaders to sign any document required by the Hospital authorities.(required)

5. I am happy for photographs of my child to be used in The Green Outdoors publications.(required)

Are you the child’s legal parent or guardian?(required)

Parent or Guardian Name(required)

Date(required)

I understand the questions on this form and have given replies to them.(required)

Thank you for contacting us, we will respond very shortly.

Advertisements