Riddings Junior Camp – Amber Valley School Sport Partnership CIO

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Number of Children*:

If you require a booking for more than 2 Children, please complete a second booking form.

Child 1 Full Name*:

Child 1 D.O.B* (dd/mm/yy):
Invalid date (dd/mm/yy).

Child 1 Emergency Contact Number*:

School*:
]

School Year*: (Children must be aged 8-13 years old)

Medical Info*:

Dietary Requirements/Allergies*:

Special Educational Needs/Disability Information*:

Does your child recieve regular 1to1 support in school?*:
Yes No

Please only complete Child 2 details if you have selected 2 Children from the option above.

Child 2 Full Name:

Child 2 D.O.B (dd/mm/yy):
Invalid date (dd/mm/yy).

Child 2 Emergency Contact Number:

School:

School Year:(Children must be aged 8-13 years old)
]

Medical Info:

Dietary Requirements/Allergies:

Special Educational Needs/Disability Information:

Does your child recieve regular 1to1 support in school?:
Yes No

Parent Name*:

Email*:

Phone* (please ensure that you have provided us with two different contact numbers):

Postcode*:

Any Additional Info:

Please state whether you give persmission for the child(ren) included in this booking, to be dismissed without adult collection at the end of the day.

Do you agree to photos to be taken of your child for marketing and promotional materials? Yes No

Do you agree to information being stored and processed for communication purposes in accordance with GDPR? Yes No

Please tick to state you have read and agree to our Terms and Conditions. Agree

Riddings Junior School – Holiday Camp