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Nova Street Easter 2023 - Torquay
Booking and consent form for Nova Street @ Torquay. Please complete 1 form per child.
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* Indicates required question
Email
*
Your email
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
3. Child like to be known as
Your answer
4. School
Your answer
5. School Year
*
Your answer
6. Parent/Carer name and contact
*
Your answer
7. Second Emergency Contact Name and Number, and relationship to child
*
Your answer
8. Which dates would you like to book your child to attend Nova Street Summer Sessions? (Times are 12:00-16:00)
*
Mon 3rd April
Tues 4th April
Wed 5th April
Thurs 6th April (Bowling Trip)
Required
9. Does your child receive free school meals?
Yes
No
Not Sure
Clear selection
10. Emily can take part in all activities, no health problems or medication no
Your answer
11. Does your child suffer from any allergies? Please state. No
*
Your answer
12. Does your child have any dietary requirements? No
*
Your answer
13. Is your child able to manage their own self care?
Yes, they won't need any support from team
Mostly, but they may need some help and will ask if they do
They will need quite a bit of support
Clear selection
14. Are you happy for your child to make their own way home?
Yes - whenever they feel they want to
Yes - as long as you notify me when they leave
Yes - as long as it is the end of the session (16:00)
No
Other:
Clear selection
15. In an emergency, and if I am not contactable, I am willing for my child to receive hospital treatment, including an anaesthetic. (NB: The leader of the activity would always try to contact you in the first instance.)
*
I consent
I do not consent
16. I give permission for photos and video to be taken by the team members of my child during the sessions that may be used for marketing or publicity purposes - these may be shared with the school, on social media and the wider community.
*
I consent
I do not consent
17. I give permission for representatives of LOVE ENTERPRISE GROUP CIC to share information that relates to my child with children's services (who fund this programme) for reporting purposes.
*
I consent
I do not consent
18. I understand, for the data captured on this form to be stored as a hard copy with an electronic copy on a secure cloud storage system that can be accessed and utilised when necessary by coaches, other volunteers and team members in the case of an emergency or for updating, marketing and informing on matters relating to LOVE ENTERPRISE GROUP C.I.C and promoting events of interest by it’s partners. (to withdraw consent please email:
stefan@glotorbay.co.uk
)
*
I consent
I do not consent
19. Signature of Parent (typing your name is sufficient)
*
Your answer
If any illness occurs after having sent this form, please give written details to your child to bring with them to the sessions.
Thank you for completing this booking form.
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