Dunkeld Playscheme: Summer 2019
Please use this form to request places for your child/children, we will be in touch to confirm your booking shortly.
Full Name of child/children *
Your answer
Age of child/children *
Your answer
Name of Parent/carer *
Your answer
Main contact number *
Your answer
Alternative contact number *
Your answer
Email *
Your answer
May we add you to our e-list for Playscheme updates? *
Has your child/children attended Wild Sparks before? *
Dates you wish to attend
Wednesday 3rd July
Wednesday 10th July - FULLY BOOKED
Wednesday 17th July
Wednesday 24th July - 1 SPACES LEFT
Wednesday 31st July - FULLY BOOKED
Wednesday 7th August
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? *
Your answer
Emergency Contact details
Please give details of two alternative contacts in case of an emergency below
Person 1: Name & relationship to child
Your answer
Contact number
Your answer
Person 2: Name & relationship to child
Your answer
Contact number
Your answer
Name of registered doctor / surgery
Your answer
Contact number of Doctor / surgery
Your answer
Do you give consent for Wild Sparks staff to: *
Administer first aid (where suitably trained) and seek emergency medical advice and treatment
Apply hypoallergenic sun cream
Apply Smidge insect repellent
Apply Anthisan to wasp/bee stings
Apply arnica cream to bumps
Apply face paints
Remove a tick (using a tick remover tool)
Please tick to confirm that you understand the following *
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.
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.

Wild Sparks Facebook/Twitter/Website
Printed marketing materials
Internal reports & training materials
Funders' reports / websites
Your answer
Please use this space to ell us anything else it might be useful to know about your child to support them to be safe and happy out in the woods (e.g. is afraid of heights, gets cold easily)
Your answer
Is there anything else you would like to tell or ask us?
Your answer
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.

Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service