Oct break ‘25- B.R.E.A.T.H.E. holiday workshops Registration Form

Parent/Carer Name*

First NameLast Name

Choose session

Kids ‘LETTING GO’ session ~ 15th OCT ~ 10am - 12 noonTween/teen ‘LETTING GO’ session ~ 15th OCT ~ 1pm - 3pm

Wait list

KidsTween / teens

The kid's classes are most suitable for children from around P2-P6 and the Tween/Teen sessions are most suitable for those children around P6-S2 age range, although as parents know their chldren best this can be flexible.

The children's classes are always well attended, however less so the teen ones. this year I will go ahead with the teen ones if I meet a minimum of 5 participants.

I will keep everyone informed along the way through the Parent holiday '25 Pop-Up fabebook group.

Classes for the kids and teens have the same titles but will of course be differentiated to meet the needs and contexts related to specific ages and stages of the participants within the groups.

Payment is made when booking. Payments are by bank transfer. Details are shared in this form and pinned within the parent facebook group. I will follow up with a mesaage or email and payment details will be within their also. a link for the parent group will also be in the email.

Refunds will be offered if 7 days notice given. If less than 7 days then money is transferrable but not refundable.

Child/Teen Name*

Age *

Address*

Street Address

Street Address Line 2

Town/CityTown/City

PostcodeCountry

Phone Number*

Email (for replies and Creative Coaching information only)*

example@example.co.uk

Please select for additional use of Email address by EmotionALL

EmotionALL newsletter/information regarding Children and TeensEmotionALL newsletter/information regarding Adults

Emergency Contacts

1st Emergency Contact*

Relationship To Child*

Contact Number*

2nd Emergency Contact (optional)

Relationship To Child

Contact Number

Safeword if someone else is picking up your child/teen that I have not been made aware of (optional and age appropriate)

Mostly needed for kids sessions.

Does your child/teen have any learning differences, medical needs, or any support needs? This will allow the coach to successfully build inclusive sessions to suit your child/teen group classes. Please give brief detail below~ *

As holiday sessions are 2 hours long I do supply a drink and snack for a 15min break. If your son/daughter has any dietary requirements please let me know? They are of course welcome to bring their own drink and small snack.*

General options are diluting juice/water and plain biscuit selection.

Does your child/teen take or require any medication that the coach needs to be aware of in case of an emergency?*

(Required in case of emergency only. No medications will be given on site. With some medications parent/carer may need to stay on site and some may warrant a further discussion/care plan)

Please share relevant medication information here.

B.R.E.A.T.H.E. sessions may include games, yoga, mindful meditation, breathe work, essential oil, positive touch, creative crafting, as well as coaching conversations and wellbeing learning & teaching. Is your son/daughter happy to give all elements of the class a go?*

If NO or if you wish to Further Discuss please share any concerns here so that we can correspond and work through things.

EmotionALL Coaching and Wellbeing takes all reasonable care to ensure that all sessions are safe and that they endeavour to provide the highest levels of health and safety and duty of care at all times.

Risk assessments are completed for each block of classes to minimise any risks.
Accident forms are completed and stored as appropriate.
Physical First Aid and Mental Health First Aid are undertaken regularly.
Child Protection and Safeguarding Training undertaken regularly.
Public Liability Insurance for all services delivered
CCTV both inside and outside the Studio, for the safety of all.

Parent/Carer

I individually as a parent/carer of the child identified above hereby agree to the following:

I understand that my child will be engaging in a moderate amount of movements and activities alongside others, and this brings about a normal amount of risk.

In the event of emergency and in the absence of being able to reach a parent/carer I agree to EmotionAll Coaching and Wellbeing making a 'duty of care' decision to contact Emergency Services.

If a parent/carer/listed emergency contacts cannot be contacted following a reasonable time passed beyond pick up (approx 1hr 30 mins), I understand that local duty Social Services/Emergency Services may need to be contacted to ensure to ensure your child's safety.

I understand and agree to all the above information?*

A call can be arranged to further discuss any of the above areas.

If Don't Agree or Discuss Further have been selected please share any questions and concerns below and we can correspond to work through these.

Photographs: I give permission for my child/teen pictures to be used for sharing class information and promotional purposes within EmotionALL social media and website & also for sharing within the private parents groups to share learning and highlights of sessions.*

I always ask child/teen permission also as I respect their feelings and choice to have their picture taken at any given time. General group shots and pictures of their crafts are most common.

I agree to pay the full amount at time of booking to fully secure my bookings? (Bank Transfer Details on this form and/or displayed on the holiday Pop-up facebook group page). I understand that my class place may be given to someone on the waiting list if I have not made payment or communicated any payment issues directly with EmotionALL *

If full payments cause financial hardship I am always open to discuss options. Refund can be given up to 7 days before. with less than 7 days payments are transferrable but not refundable.

Please share any concerns with the above photo and payment information and we can correspond be to work through this.

BANK PAYMENT DETAILS

ACCOUNT NAME - Pauline Lawson

ACCOUNT NUMBER - 10836153

SORT CODE - 83-17-26

How did you hear about EmotionALL and Creative Coaching Sessions?

Signature

Date*

Oct ‘25 B.R.E.A.T.H.E. WORKSHOPS for Kids, Tweens, Teens