LBBD Premier Education Easter HAF Enquiry Form 2024

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Camp times are 9am-3pm daily. This camp is for primary-aged children. COMPLETION OF THIS FORM DOES NOT CONFIRM A PLACE. WE WILL REVIEW DETAILS AND INDIVIDUAL PLACES WILL BE CONFIRMED VIA EMAIL IN DUE COURSE. Please note that each child can attend a maximum of 3 days over the Easter break.

Please read and answer all questions thoroughly, giving full details where requested. Incomplete forms will not be considered.

Email *

Please select your preferred camp location *

Roding Primary School (Cannington Road Site)

Marsh Green Primary School

Rose Lane Primary School

Manor Junior School

Please state your preference for booking (please note that preference cannot be guaranteed) each child can attend for a maximum of 3 full days. *

2nd April (Rose Lane and Roding Only)

3rd April (Rose Lane and Roding Only)

4th April (Rose Lane and Roding Only)

5th April (Rose Lane and Roding Only)

8th April (Marsh Green and Manor Junior Only)

9th April (Marsh Green and Manor Junior Only)

10th April (Marsh Green and Manor Junior Only)

11th April (Marsh Green and Manor Junior Only)

Required

Child's First Name *

Child's Surname *

Child's DOB *

YYYY

Child's Full Address *

Child's Post Code *

Child's School *

Child's School Year Group *

Parent/Carer Name *

Parent/Carer Email Address *

Parent/Carer Contact Number *

Second Emergency Contact - Full Name & Relationship to Child *

Second Emergency Contact - Phone Number *

Does your child receive benefit-related free school meals, or do your circumstances mean that have you been offered a funded place? Please note that this does not include the universal free school meals for all children in Reception - Year 2. *

Yes - in receipt of benefit-related Free School Meals

Yes - We have been offered a funded place for the programme due to circumstances or we believe we are eligible

Does your child have any special educational needs or have a disability? If 'no' please type - None. If 'yes' please give FULL details. *

Does your child need a 121 support? - If NO please put N/A if YES please give FULL details below *

I am giving Premier Education and LBBD Council permission to take photographs and / or video footage of my child when attending this Premier Education session. I grant full rights to use the images resulting from the photography/video, and any reproductions or adaptations of the images for publicity or other purposes to help achieve the projects aims. This might include (but is not limited to), the right to use them in printed and online publicity, social media and press releases.

Yes - I do give permission

No - I do not give permission

Does your child have any dietary requirements or allergies? If 'no' please type - None. If 'yes' please give details. *

Password for collection of Child/Children *

Child's Ethnicity *

English, Welsh, Scottish, Northern Irish or British

Irish

Gypsy or Irish Traveller

Any other White background

White and Black Caribbean

White and Black African

White and Asian

Any other Mixed or Multiple ethnic background

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background

African

Caribbean

Any other Black, African or Caribbean background

Arab

Any other ethnic group

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