Sickle Cell Society Children's Holiday 2019 Application
**IF YOU ARE FILLING THE FORM IN BY HAND, PLEASE POST IT TO SICKLE CELL SOCIETY, 54 STATION ROAD, LONDON, NW10 4UA. We will automatically receive all online applications**

Please fill in the below form if you would like your child attending the Sickle Cell Society Children's Holiday 2019.

The Children's Holiday is between 10th and 14th August at Condover Hall (Shropshire). Children aged 8-15 years old are able to attend. The trip is FREE for children to attend (this includes all accommodation, food and a whole host of exciting activities). Transport will be provided from Central London at no extra cost. There will be experienced doctors and nurses to provide all medical care during the week - your child will be in very safe hands.

All children who attend the holiday must have Sickle Cell Disorder.

Please note that your child's place on the holiday is not guaranteed - we are always oversubscribed and have to put children on the waiting list. If your child has attended previous Sickle Cell Society holidays you are more than welcome to apply but children who have not attended a holiday before will get priority.



1) Fill in the below form
2) We will acknowledge your application - if you don't receive acknowledgement, please let us know - your application may have got lost.
3) We will request a recommendation from your child's consultant/nurse - this is essential to process your application.
4) You will hear from us after 1st April as to whether your child will be offered a place on the holiday. If they are offered a place there will be additional forms to fill in/sign and you will receive a booklet of information about the trip.

If you would like to withdraw your application at any point, please let me know as soon as possible.

Please do not hesitate to contact me if you have any questions or worries - I am more than happy to meet with you and your child before the trip takes place, or to have a conversation on the phone. My e-mail is I am not office based so please do send an e-mail if you would like to chat on the phone and I will arrange a time to call you.

I look forward to receiving your applications!
Child's Full Name *
Child's Date of Birth *
Child's Gender *
Child's Home Address *
Child's Postcode *
Full name of Parent/Carer 1 *
Parent/Carer 1 e-mail address *
Parent/Carer 1 telephone number(s) *
Full name of Parent/Carer 2
Parent/Carer 2 e-mail address
Parent/Carer 2 telephone number(s)
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