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Clip 'n Climb SEND Sessions
Pre-screening questionnaire
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Thank you for booking your place at the Clip 'n Climb Thanet SEND session, in partnership with Inclusive Sport.
Please complete a form for EACH child that is attending.
Child Full Name:
*
Your answer
Child Age:
*
Your answer
School they attend:
*
Your answer
Does your child have an Education Health and Care Plan (EHCP) in place?
*
Choose
YES
NO
Medical Health Needs / Conditions:
*
Your answer
Learning Needs/Support
*
Your answer
Communication Needs/Support
*
Your answer
Parent/Guardian/Carer Full Name:
*
Your answer
Relationship to child:
*
Your answer
Contact Number:
*
Your answer
I give permission for photos/videos to be taken of my child. These may be used for Clip 'n Climb/Inclusive Sport publications, social media and advertising. They will be stored securely - data protection policy available on request
*
YES
NO
Required
I give permission to be contacted by the Clip 'n Climb/Inclusive Sport team in relation to this enrolment if necessary.
*
YES
NO
Required
Confirmation
By fully completing and submitting this form you have booked your space.
We will contact you if we need any further information or if your booking cannot be accepted.
Thank you
Clip 'n Climb Thanet
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