LightBeam Academy Winter Camp

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Fun Vibes, Active Lives provided by LightBeam Academy in Partnership with Pendle Borough Council

Child's First Name *

Child's Surname *

Child's Date of Birth *

YYYY

Child's age and School Year group *

Child's Gender *

Child's Home Postcode *

Child's Home Address *

Child's School *

Does your child receive benefits related free school meals? *

Yes

Did your child's school inform you of this HAF Winter provision? *

Does your child have any additional support needs? *

Does your child have any special dietary requirments? Please list allergies. *

Does your child have any medical condition that require extra support? *

Name Of Parent/Carer/Guardian *

Email Of Parent/Carer/Guardian *

Mobile Number of Parent/Carer/Guardian *

Name and Number of Emergency Contact Person *

Photos and keeping in touch *

I give permission for my child's photograph to be taken and used by LightBeam Academy, as stated in the LightBeam Academy Photography Policy on the website.

I agree to receive updates by email, post, phone, SMS and other electronic means from LightBeam Academy.

Required

Disclaimer

By booking on Fun Vibes, Active Lives session provided by LightBeam Academy, you consent to us sharing contact details with Pendle Council and Lancashire County Council. All data will be held confidentially and will only be used to: • ensure you meet the criteria for free provision • monitor & evaluate the effectiveness of the scheme. Your details will be held by Pendle Council until the end of January 2024 and the data won't be shared with a Third Party. All paid places are non-refundable.

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