Holiday Camp Enrolment Form 2020
Wee Chicks Holiday Camps run over Mid Term, Easter, Summer and Halloween breaks. We operate from 8.30 am – 3.00 pm.
Please visit our Website for up to date information.

If have have any further queries please email
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Email *
Details will be held securely and in line with the Data Protection Act. Marketing Permissions: Wee Chicks will use the information you provide on this form to be in touch with you and to provide updates and marketing. Please let us know all the ways you would like to hear from us. You can change your mind at any time by contacting us at We will treat your information with respect. For more information about our privacy practices please visit our website. By clicking below, you agree that we may process your information in accordance with these terms.
Child’s Name: *
Date of Birth: ___/___/___ *
Age of child on entry? *
Parent/Guardian name on birth certificate: *
Do you have parental responsibility for the child? *
Your Contact Phone number: *
Alternative Phone Number: *
Do you have parental responsibility for this child? *
We need two contacts to be held on file Parent/Guardian Name: *
Is the above names on your child's birth certificate? *
Contact Phone Number: *
Alternative Phone Number:
Who is authorised to collect your child. Only people named can collect your child. They must be over the age of 18 and show ID on collection of your child. Name and Password: *
Telephone number of person collecting your child if different from above: *
Name child prefers to be called:
Child’s Address : *
Does your child understand English? *
Is your Child on any medication? *
(if yes please give details)
Is your child up to date with immunisations? *
Does your child have any allergies? *
If yes please specify:
Doctors Information Name: *
Address: *
Telephone number: *
Does your child have any impairments?
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Please give details:
Do you have any additional Cultural and/or Religious beliefs?
Additional Comments & Information: Is there is any other information that would be helpful to our management and staff? for example behaviour triggers, dislike, being assessed, or waiting on assessment, low mood, anxiety due to Covid 19?
Has your child or anyone in your house hold had Covid 19 from pandemic?
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Do you know what website to go to to check for update guidance on Covid 19? ( will send you the link!)
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Parental/Guardian Consent (tick as appropriate) I/We give my/our permission to act on my/our behalf in case of emergency or accident and to take such action as may be necessary for the benefit of the child. The decision to be taken by the person in charge at the time of the emergency *
I/We agree to pay all reasonable costs/expenses which might be incurred in this event. *
I/We give my/our permission for my/our child to be photographed by staff for the purposes of displaying in the units? All photographs will be destroyed when the display is taken down. *
I/We hereby give my/our permission for my/our child to be included in press releases issued by Wee Chicks Fitness CIC / Wee Chicks LTD
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I/We give my/our permission for my/our child to be photographed by staff for the purposes of use on our website and social media.?
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I/We hereby give permission for my child to be given Calpol/Nurofen (delete if appropriate) when
necessary by the unit manager or assistant. *
I/We hereby given permission for hypo allergenic plasters to be used on my/our child if necessary? *
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I/We hereby give my permission for staff to assist with cleaning my child in the event of a toileting
accident. *
I/ We hereby give permission for staff to apply sun cream to my child if necessary *
I/We agree to give notice to Wee Chicks Fitness CIC / Wee Chicks LTD when changing days of attendance. If your child does not turn up for a session they are book in for, the session cannot be transferred. At least 48 hrs notice required for change of days *
I/We give Wee Chicks permission to take my child to the Waterworks, Cavehill, Belfast Castle and Chichester Library and local walks.
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I/We give Wee Chicks permission to be transported in Wee Chicks cars?
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I/We hereby agree to terms and conditions of payment of fees which is payment weekly in advance of days of attend. If your child fails to attend you agree to pay the fee. *
Additional people Who is authorised to collect your child? Name & Password:
Telephone Number:
Date of birth:
What dates would you like to book? Full day: 9am-3pm, Early drop off (8.30am) and late pick up (latest 5.30pm) are available.
Parent/Guardian signature: By typing your name it is accepted as an electronic signature. *
A copy of your responses will be emailed to the address you provided.
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