Oxygen Summer '21 Activities Form
Oxygen is a youth work charity and all its staff and volunteers are D.B.S. checked and have undergone approved safeguarding training. You can find out more information about Oxygen at
The Oxygen team are pleased to be hosting a range of sports, creative and outdoor activities during the Summer on selected dates from the 27th July to the 26th August. Our team will be hosting a range of various activities including table tennis, badminton, football, volleyball, t-shirt printing, mystery clue hunt, park walk and music workshop.
Our Summer programme is taking place at Kingsnympton Youth and Community Centre, Kingsnympton Park, KT2 7RW (access via Kingsnympton Estate from Kingston Hill).
The age range is 10 - 16 years old. For more information about what's on, please visit the Kingsnympton page on the Oxygen website:
Dates and times may be subject to change depending upon take up of places, staffing and covid restrictions should they be in place. For two weeks of the programme we are working alongside the youth service team from Achieving for Children.
For support with booking you can also contact Oxygen via email at
or by phone on 07908815352
I give consent for Oxygen to retain the information on this form for the purposes of my son / daughter taking part in Oxygen activities. If you do not give consent here then we cannot provide activities or support.
Parent/ guardian name
Parent / guardian's contact number
Your relationship with the young person named below: (father, mother, etc)
Young person's name (in full):
Young person's date of birth
Please select the days and times young person would like to attend
Tuesday 27th July 12.00 - 16.00
Thursday 29th July 12.00 - 16.00
Tuesday 3rd August 12.00 - 16.00
Thursday 5th August 12.00 - 16.00
Tuesday 10th August 12.00 - 15.00 Run by Achieving for Children
Wednesday 11th August 12.00 - 15.00 Run By Achieving for Children
Thursday 12th August 12.00 - 15.00 Run By Achieving for Children
Tuesday 17th August 12.00 - 15.00 Run By Achieving for Children
Wednesday 18th August 12.00 - 15.00 Run By Achieving for Children
Thursday 19th August 12.00 - 15.00 Run By Achieving for Children
Tuesday 24th August 12.00 - 16.00
Thursday 26th August 12.00 - 16.00
What school does the young person attend?
Is the young person eligible for free school meals. If"yes" then Oxygen can apply for additional funding and support.
Any allergies or medical conditions
Yes. If so please give details below
Details on allergies or medical conditions:
Please tell us about any medical needs your child has and what medication they are on or need to have with them.
Name and address of GP
I give consent for my son / daughter to access youth work activities and support through Oxygen
Maybe. I would like more information on these activities
Send me a copy of my responses.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service