Gender
Please tick the dates your child will be attending the Holiday Camp. Children must sign up for at least 3 days over the 5 days (they do not need to be consecutive days).

Medical Information

Does your child have any disabilities we need to be aware of? If yes, please outline the support they require.

Does your child have any medical issues we need to know about. If yes, please outline the support and/or medication they require.

Does your child have asthma? If your child has asthma they must be provided with an asthma pump.

Does your child have any allergies? If yes please outline.

Medical Information

Contact 1

Contact 2

Agreement (Please Tick)

I will ensure my child attends the Summer Camp on the days I have stated and is on time. I understand that if my child arrives late their place may be taken. If they are consistently picked up late they may not be able to continue attending.

I will ensure the correct payment has been made. (Failure to do so will result in your child being unable to attend.)

I will ensure that my child is provided with a suitable packed lunch and a bottle of water.

I understand that if my child’s behaviour is unsatisfactory, or they do not listen to the coaches, they may not be able to continue attending.

I allow photographs of my child to be taken strictly for the use of
First Kicks Ltd Promotion.

I understand that once payment has been made there will be no refunds. (If your child is ill they will be allowed to come another day)

I allow First Kicks staff to administer first aid to my child and make medical decisions in my absence (We will always contact parents should a medical situation arise). Please ensure you save our number upon arrival and always answer the phone.

Once you have submitted your form. please use the pay now button to make a payment for your child place. 
Add your child name in the notes please.