Sweet Circus Participation Questionnaire and Waiver
Sweet Circus is a non-profit community organisation. This form contains and collects essential information to keep all participants safe and help us provide the best experience possible.  We also collect monitoring information to help us and funders monitor our effectiveness.  We never sell your information on to other third parties.

Please complete this form before your first session with us, and notify us of any changes.  Many Thanks :)

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What is your Email Address: *
Grab a Cuppa ...

This is a google form.  It cannot be saved and returned to so you need to complete it all in one go.  It is not the most interesting thing you will do in your life, but it is essential to keep participants safe while enjoying our activities.  It should take about 5 or 6 minutes to complete. You will need the contact information of yourself and an emergency contact but aside from that you will probably know all the answers that are required.  

If the participant is under 18 years old, this form must be completed by their parent or carer.

A separate form must be completed for each participant at least once a year. If you are booking more than one child, or an adult and a child this form must be completed once for each person. If any of the details on this form change please inform us at your earliest opportunity.

So grab yourself a cuppa, get comfy, and away we go!!

I NEED A FREE CLASS!!
Sweet Circus have a pay it forward scheme for adult classes which provides a free class to people who really need / want to participate but genuinely cannot afford it.
If a person cancels at short notice we will offer their space to a person on this list.  Occasionally classes are donated and we sometimes receive funding to provide free sessions.
To join this list please answer "I need a free class" to the next question, you will then be placed on the list :)  we still need you to complete the rest of the form!
This is currently only available for Adult participants on adult classes.


First please tell us who you are: *
Your Name: *
Your Phone Number: *
Your Address *
Now please tell us the participants full name: *
Participants Date of Birth: *
Participants Age: *
Participants Postcode: *
Participants Email (if different from above):
Participants Phone Number (if different from above):
A bit of Essential Reading:
Sweet Circus Informed Consent Waiver:

Despite careful planning and delivery all physical activity workshops carry an element of risk so it is important that you read this information carefully.  Our sessions are designed to minimise those risks. If you are unsure of  something, please ask.

Any healthy persons are welcome to register for an appropriate session, there are age restrictions and eligibility criteria on some activities so please check these before registering.

All participants will need to listen to and watch their instructors in order to practise safely and should be mindful of other people's safety during the session.  Participants should show respect to themselves, each other, equipment and instructors.  Participants will not be forced to do anything, however, not participating in one section of a session may mean that it is unsafe for you to to participate in activities which follow.

Participants should only use equipment under our guidance, especially aerial equipment.

Participants are advised to wear suitable clothing that covers the back of the knees, arm pits and midriff such as leggings / joggers and a t-shirt that can be tucked in.  A warm layer is also recommended.  Jewellery should be removed.  Please bring a water bottle, visit the toilet and wash your hands before the session.

Let your instructor know if you feel you can’t do something, or if you experience excessive pain and they will advise you.  Participants are likely to experience some bruising or tenderness on contact points especially with aerial equipment. As with any exercise you may feel achy for a few days after the first session.

Photographs are often taken and uploaded to our social media sites for you to download. These are used to report back to our funders and to show potential funders the great work we do.  We sometimes use these for marketing purposes but you can request that they be removed at anytime by contacting us through Email. If there is a specific reason why your images cannot be used please contact us on info@sweetcircus.net.

Should you have any queries please do not hesitate to talk to one of our instructors before your session.
Please tick here to confirm that you have read and understood (or discussed with your child) the informed consent waiver (above).  You agree to participate (or for your child to participate) in the session. You understand that you can stop participation in the session at anytime should you not feel comfortable to continue. *
Required
Does the Participant suffer from any of the following: Heart Condition / Chest Pain / High or Low Blood Pressure / Fainting or Dizzy Spells / Asthma / Diabetes / Bone or Joint issues / Had an Injury or Operation in the Last Year / Allergies / Is Taking any Medication / Other Medical Issue not mentioned here? *
If you answered Yes or Maybe to the previous question please provide details here:
Is the Participant Pregnant or Postnatal *
Does the participant have any additional needs? (please tick all that apply): *
Required
If you answered yes or other to the previous question please provide details here:
Is there anything else you feel we should know?  Or anything we can do to help you engage and enjoy our sessions:
If the Participant has any dietary requirements (ie, vegetarian or allergies) please provide information here:
Please provide the Name of one Emergency Contact (you will have the option to add another): *
Emergency Contact telephone number(s): *
If you would like to provide further emergency contacts please detail their names and phone numbers here:
Sweet Circus would like to keep you informed of future workshops, products, circus jams, events and classes that may be of interest to you. We take your privacy seriously and will not bombard you or pass your information on to others. You can opt out at any time by emailing info@sweetcircus.net.
Covid 19, Assumption of Risk:
Coronavirus or Covid-19 has been declared a worldwide pandemic by the World Health Organisation.  It is extremely contagious and can cause severe and long term health difficulties and even death.  Sweet Circus has put in place preventative measures to reduce the likelihood of Covid 19 spreading during our sessions, however we cannot guarantee that you or your child(ren) will not become infected with Covid- 19.  Attending any face to face activities or using our equipment is done so entirely at your own risk.  Our full Covid policy and risk assessment is available on our website.

Participants and parents are expected to follow preventative measures as guided by sweet circus. Participants should not attend if they or someone in their household is experiencing covid symptoms (new cough, high temperature, loss of taste / smell). Participants should notify Sweet Circus if they test positive for covid -19 within 14 days of attending our activities.

Please check the box below to acknowledge that you have read and understood the information above.  By checking this box you voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to your self or your child(ren).  You are stating that you are aware of the risks of potential exposure to covid-19 and will not hold Sweet Circus responsible should you or your child(ren) become infected before, during or after participation. *
Required
Eligibility Criteria
From time to time Sweet Circus receive funding to support specific groups to engage in our activities.  In order to receive a funded place (either now or in the future) we need to produce this information to the council or other funder.  We also use this information to seek funding.  

If you are booking a funded place on a holiday club or enrichment programme it is essential that you complete this section.
Does the Participant fall into any of the following categories? (tick as many as apply):
Equality and Diversity monitoring
It is important to Sweet Circus to strive to be as inclusive as possible.  Sometimes funders require us to collate equality and diversity information.
What is your (the participants) Ethnic Group?
Do you (the participant) have a disability?
Clear selection
Is your (the participant) gender the same as that assigned at birth?
Clear selection
Do you (the participant) suffer from any long term health conditions?
Clear selection
Do you (the participant) suffer from any mental health conditions?
Clear selection
Do you (the participant) have a learning difficulty / disability?
Clear selection
Do you consider yourself (the participant) to be:
Clear selection
Congratulations  - You've made it to the end of the form!
Well done!  You deserve a reward!
That was a question marathon, thank you so much for taking the time to give us all the information we need to provide the very best service.
At least you know you probably won't have to do it again for another 12 months.

We can't wait to see you :)
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