High Springers Holiday Day Camps Booking Form

The minimum age is 4 years old. You may add more than on child but a medical and a  declaration form is required for EACH child.
* All input fields below, except the optional additional children places, are required (*).

Monday 3rd April
Tuesday 4th April

Monday 10th April
Tuesday 11th April
Wednesday 12th April
Thursday 13th April

1 Day £28
2 Days £53
3 Days £76
4 Days £99
+ £3 booking fee per family

CHILD 1




Gender*
boygirl


CHILD 2




Gender
boygirl


CHILD 3




Gender
boygirl


EMERGENCY CONTACT INFORMATION





9.00am-3.00pm at St.Margarets School Sports Centre, WD23 2TD

CHOICE OF DAYS*

MEDICAL / HEALTH INFORMATION

Please give details of any medical condition, allergy or health needs that the club should be aware of (including medicines that may be needed during a session – e.g. inhaler, epipen etc.).
Please supply any additional information on conditions that may require extra consideration by staff
(e.g. recently broken bone). It may be necessary to seek medical advice to confirm that participation in trampoline and/ or or gymnastics activity will not have a negative impact on health.

Do you consider the participant to have a disability?
NoYes

Visual impairment/ Hearing impairment/ Physical disability/ Learning disability/ Multiple disability
NoYes

PHOTOGRAPHY / VIDEO RECORDING*
In line with our child protection policy, we would like to point out that we often make use of video recording to improve performance during training sessions and at competitions. On occasion articles with photos or videos may be placed on the club website/ facebook page or advertising.

I give permission for the use of photography and video with me/my child by any of the club coaches.*
YesNo
I give permission for the use of photography and video with me/my child to be used on the internet.*
YesNo
I give permission for the use of photography and video with me/my child to be used for any leaflets/posters/banners or newsletters.*
YesNo


DECLARATION
Trampoline and Gymnastics is an active sport and so has an inherent risk of injury. High Springers will endeavour to minimise any risk or accidents. It is incumbent on all participants to make themselves aware of and abide by the safety rules, policies and codes of con-duct at all times. High Springers does not accept responsibility for any injury (howsoever caused) sustained as a result of the injured party acting contrary to instruction, whether express or implied. I agree that a club coach or representative may act in loco parentis in the event of any accident or injury, if I or my emergency contact cannot be reached. I confirm that I am physically fit and healthy and I consider myself capable of taking part in Trampoline and/or Gymnastics. I have honestly completed all necessary forms. This includes any head injuries or accidents resulting in unconsciousness that I have had within the past six months. I will inform the coach at each session of any medical condition, injury or medication that may in any way affect my ability to participate in the sport. I understand that an instruction may be a verbal, visual, physical or demonstrative form of communication. I will ask for further clarification of any ambiguous and/or inaudible instructions.
I understand that if behaviour places myself or others around me at risk of danger or injury that I will be refused entry to any session at the discretion of the coach.
By signing this participation agreement, I declare that I understand the element of risk and am willing to participate/for my child to participate. I have read and understood the Club’s policies and code of conduct for members/parents and agree to abide by them (full details are included in the Club’s welcome pack and can be obtained by contacting the club direct).





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