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Alyth Playscheme October 2017
Please use this form to request places for your child/children, we will be in touch to confirm your booking shortly.
Name of child/ren
Your answer
Age of child/children
Your answer
Name of Parent/carer
Your answer
Email
Your answer
Phone number
Your answer
Has your child/children attended Wild Sparks before?
Dates you wish to attend
1
Mon 9 October FULLY BOOKED
Tue 10 October
Thu 12 October
Mon 16 October
Thu 19 October
Fri 20 October
Does your child have any allergies, dietary or medical requirements?
If yes , please provide details (e.g. uses inhaler/dairy intolerant)
Your answer
Does your child have any extra support needs in addition to those mentioned above?
details
Your answer
Do you give consent for Wild Sparks staff to:
Yes
No
Administer first aid (where suitably trained) and seek emergency medical advice and treatment
Apply hypoallergenic sun cream
Apply insect repellent / bit relief
Apply arnica cream
Apply face paints
Remove a tick (using a specialist tick remover)
Please tick to confirm that you understand the following
Yes
My child/ren are likely to get muddy, old clothes are advised.
My child/ren may use tools, light fires, climb trees and take part in other 'risky play' activities*
My child/ren will be encouraged to challenge themselves. Whilst safety is paramount we do not entirely eliminate risk from all activities*
Children are expected to show responsible behaviour and that any form of behaviour that poses danger to themselves or other children, or that is recurrently disruptive for the group may (as a last resort) result in them being excluded.
Parents / carers are responsible for the safe travel of their children to and from the site. Parents/carers are responsible for children up to and after they have been signed in and out each morning and afternoon.
My child can be collected by the following named people:
Your answer
Photographic/video consent
At Wild Sparks we take lots of photos and occasional film footage which we use for a number of purposes. Please indicate below how we may use photos/video footage of your child/ren.

If you have very specific concerns/requirements around use of photos/film of your child/ren please get in touch to discuss details and ensure absolute clarity.

Yes
No
Wild Sparks printed marketing materials, funding reports & press releases
Wild Sparks website
Wild Sparks Facebook & twitter
External websites / publicity materials (e.g. website of one of our funders)
Other (detail below)
details:
Your answer
Additional comments or queries
Your answer
CANCELLATION POLICY
Please make sure you are committed to attending on the dates that you request. Once your request is received we will send an email to confirm the details of your booking and request payment. At this point your booking is considered confirmed, should you need to make any changes you must notify us as soon as possible.

Cancellations made less than 14 days prior to the day of attendance will not usually be refunded, though we will use our discretion to find an agreeable resolution and show understanding towards instances of illness or other unforeseeable circumstances.

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