RESERVE LIST BOOKING FORM ONLY. Senior Club Easter Holiday Activity Project 2024 - Tuesday 9th to Thursday 11th April - Various times & fees.
For young people in school years 7 to 13 only.
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Email *
RESERVE LIST BOOKING
I understand this is the Reserve List booking form and that I will only be contacted if a place or places become available. *
YOUNG PERSON'S DETAILS
Young person's first name: *
Young person's surname: *
Young person's gender: *
Young person's ethnicity *
Young person's date of birth: *
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Young person's current School Year: *
MEDICAL INFORMATION
Does the young person suffer from any ailments or disabilities, eg diabetes, epilepsy, asthma? *
Does the young person take regular medication or receive any medical treatment at present? *
Is the young person allergic to anything, eg any particular drugs, food, insects? *
Does the young person have any particular dietary requirements? *
Is there any further information that we should know about the young person that has not already been covered, eg special needs, court orders, challenging behaviour, etc?: *
If your answer to any of the above questions is YES, please give details here:
SWIMMING
One of the activities is a trip to Coral Reef Water World.  For this activity, participants must be able to swim.
Please confirm that the young person is a competent swimmer.  
 *
(Please mark 'Not Applicable' if you are not booking a place on the Reserve List for Coral Reef.)
PARENT / CARER'S DETAILS
Parent / carer's full name: *
Your relationship to the young person: *
Your address: *
Your postcode: *
Your mobile number: *
An emergency contact: *
(The name and phone number of someone we can call in an emergency if we cannot get hold of you.)
RESERVE LIST BOOKINGS
Tuesday 9th April
Coral Reef Water World - RESERVE LIST
Time: 1.30pm to 6.30pm (approx.)
Cost: £10.00
Participants must be able to swim. 
Wednesday 10th April
Pop-Up Arcade - RESERVE LIST
Time: 1.45pm to 4.30pm
Cost: FREE
Thursday 11th April
Paintball - RESERVE LIST
Time: 12.30pm to 6.30pm (approx.)
Cost: £10.00
PAYMENTS
For trips/activities with a fee, payment MUST be made in cash or via bank transfer in advance. If a place or places become available, you will receive an email containing bank transfer instructions. Please note, the places are not secure unless payment is made.
PERMISSIONS - RESERVE LIST
If a place or places becomes available, I give permission for my child to take part in the Sulgrave Senior Club Easter Holiday Activity Project 2024 activities as indicated above. I understand this may involve travel by minibus, and/or public transport. *
Required
If a place or places becomes available, I give my consent that in an emergency The Sulgrave Club may act in my place (in loco parentis) if the need arises for the administration of emergency first aid and/or other medical treatment which in the opinion of a qualified medical practitioner may be necessary. *
Required
If a place or places becomes available, I give / I do not give my consent for my child to have their photograph taken during activities and for these to be used for Sulgrave or any other related publicity? *
I understand that by completing this form, the details I have provided will be taken, stored, and processed by The Sulgrave Club in accordance with the Club's Data Protection Policy. *
Required
Signed (your full name): *
RESERVE LIST - BOOKING CONFIRMATION
Once you submit this form, you should receive an automatic email from Google Forms which acts as confirmation of your place/places on the Reserve List. If you don't see it in your 'In Box', please check your 'Junk Folder'. If it's not there, please contact Nick on info@thesulgraveclub.org.uk. Thank you.
A copy of your responses will be emailed to the address you provided.
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