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Health and Wellbeing Camp - The Grange Easter Half Term W1
Participant data form for Sean Bailey Wellness, Health and Wellbeing Camp
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Email
*
Your email
Full Name of Child
Your answer
Preferred Name of Child
Your answer
Residential Postcode
Your answer
Date of Birth
MM
/
DD
/
YYYY
Name of School
Your answer
Days Attending
Monday
Tuesday
Wednesday
Thursday
Friday
Full Week
Recipient of free school meals?
Yes
No
Clear selection
Parent Name (s)
Your answer
Name of Parent / Person Responsible for Drop Off and Collection
Your answer
Emergency Contact Name and Number
Your answer
Dietary / Health / Allergy Requirements
Your answer
Additional Support Required
Your answer
Any Other Relevant Information
Your answer
Do you provide consent for us to share images via our social network channels
Yes
No
Clear selection
By completing this form you are giving parental consent for your child to attend
Yes
No
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Parent Name and date of completion
Your answer
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