Registration Form

To confirm your child's place at Holiday Club, please carefully fill in the form below. If you have any questions please contact us.

* - this field is compulsory

Firstname of young person: *
Surname of young person: *

Sex: *
Date of Birth:*

Parent or Carer name*
Relationship to young person*
Home telephone number
Mobile number*
Email Address

For your child's safety and protection, we need at least one additional telephone number. This may be the phone number of another relative or a close family friend. Please list the phone number(s) and who they belong to below:*

Which school does the young person attend?
Does the young person have any allergies, dietary requirements, medical condition(s), special needs or disabilities we should be aware of?
We put the children into groups for the week. Do you have any friends of a similar age you would prefer to be in the same group as?
Please choose the option relevant for your child...
Please tick the boxes below to say you agree with each statement:

* I give permission for any Holiday Club Leader to liaise and share information as required with medical staff over any essential medical treatment that my child may need, if it is not possible for me to be contacted immediately.**

* Information from this form will be securely stored in line with our Privacy Policy

* My child is expected to behave in an appropriate manner, and I agree to come and collect them from the holiday club at my expense if, in the opinion of a senior leader, their behaviour is unacceptable or endangering themselves or others.

Unnamed photos and videos of my child may be used in external publicity for Holiday Club.

Your name:*

**Note: There is no legal provision for parents to delegate the right to consent to a child's medical treatment. A child who is able to understand the issues involved in a particular treatment is legally entitled to give their own consent. For most young people this would apply to treatment for minor injuries or ailments. If your child needed more serious medical treatment, the doctor would normally need to get your consent (which could be verbal consent through a phone call) before giving treatment - although urgent life-saving treatment would not be delayed by this requirement. Nonetheless, it can be helpful for medical staff to know that the parent is happy for a holiday club leader to discuss decisions relating to the child, and to sign relevant documents relating to treatment.