Shipwrecked Easter Holiday Club sign up form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for signing up for Shipwrecked! Arr.

The data submitted on this form will be processed, held and disposed of in accordance with the policies found on our website: https://avenue.org.uk/index.php/policies.

Please complete this form once per child (e.g. if you have two children coming, please complete the form twice).

If you have any questions or queries about the holiday club please contact Mike at warriner.mike@gmail.com.

Your name *

Your relationship to the child *

Your telephone number (preferably mobile) *

Your email address (we will only use this to contact you with reference to the Holiday Club. Please check you have spelt the address correctly) *

Child's name *

Child's school year *

Please list the people (aside from yourself) who are authorised to collect your child following the sessions

If your child has any food allergies/intolerances please detail them here

If your child has any medical conditions we need to be aware of please detail them here (for example allergies to medications, asthma, anything else)

Is there anything we should be aware of that will allow us to make your child more comfortable or help them to access the sessions? (for example, special educational needs, diagnosed or otherwise)

Is there any additional information you think we need to know?

Please indicate your consent for a responsible leader to dispense plasters etc.

We will always let you know at pick up if your child has been injured. We will never dispense any kind of medication

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms