WHPC JUNIOR Camp Form 2024

WHPC JUNIOR Camp Form 2024

1 form per child. Held at Whitfield Farm, Ettington, CV37 7PN - Any problems with the form not working please contact Louise on 07528553108
Name of Parent*

First NameLast Name
Address (put post code below)*
Post code*
Mobile number *
Email*
example@example.com
Other emergency Contact Number*

Child details *

	Name of child	Child DOB	Is this their first camp?
Child 1

Pony Details*

	Name of Pony	Age of pony	Height	Experience and manners of pony
Child 1

Most recent test passed Please write name of most recent efficiency test passed (eg D Test D+ Test, C Test, or None)*
Please select your child's level of riding*
What are you /your child's goals from camp (e.g. to have fun, get their next level test, improve confidence cross country)
Please provide any information that will help us group your child (e.g. they are nervous, confident, have ridden with xx child before, or are good friends with xx*
I hereby authorise photographs/videos/other images of my son/daughter taken by the press/outside agencies, official pony club photographers to be published in the press and on the internet for publicity purposes. I understand that the pony club will select images for publication with care and respect for those shown.*
I give consent for the personal data on these forms (including medical consent) to be held in a secure place up to and including the duration of camp and I am happy to receive information about camp via my email address.*

Parents help and food rotas

Camp can't run without the support of parents and we really do appreciate your help at camp. Please can you tick which days and jobs you would like to do. Please can all parents choose at least 4 jobs, preferably on different days. You will be emailed before camp with the help list rota. ALL PARENTS ARE EXPECTED TO HELP WITH CLEAR UP ON THE FINAL DAY AND PRIZE GIVING WILL NOT TAKE PLACE UNTIL EVERYTHING IS CLEARED AWAY.
Please select 4 rota duties
Set up*
day 1 Help*
day 2 Help*
day 3 Help*
day 4 Help*
Food Rota

Our instructors give up their time, often taking time off work to support camp, we always make sure they are well fed. Please let us know if you can bring in a dish on any of the camp days (we will get in touch with you nearer the time to agree what to bring and when)
Day 1 Food Help*
Day 2 Food Help*
Day 3 Food Help*
Day 4 Food Help*

MEDICAL CONSENT FORM

This form is to be completed by the person with parental responsibility for the Pony club Member (s).

Doctors Details*

	Doctors Details
Name of Doctor
Name of Surgery
Surgery Phone Number

Allergies and Illnesses (please provide detail of any allergies and illnesses that we need to be aware of in order to keep your child safe during camp).
E.g Asthma, hay fever, special dietary requirements, ear nose throat etc)
Medications: Please list any PRESCRIBED medication that your child needs during camp (Dose, frequency, dates needed)
Religion, if relevant to Medical Treatment (or write N/A)*
Please list any other needs your child may have (and that can be reasonably accommodated at camp to ensure your child's safety)*
Does your child carry an adrenaline auto-injector? If so for what reason and what type and dose?*
Immunisations: Has your child received all expected immunisations (e.g Tetanus) If no what has been missed*
Medicines Administration by Member Of Staff Or Member

Whilst my child is away, I authorise you to give the following medicines to my child. Please state if your child carries and takes their own supply of medication e.g. asthma inhalers, contraceptive pills / implants.

All the medicines specified below have been prescribed by a registered and licensed medical practitioner and will be provided in the original packet / box / bottle with the child’s name and date of birth clearly marked. I agree that the medicines are necessary for my child, that they will be given without intending harm to the child and I indemnify The Pony Club or its Branches / Linked Centres against any loss or claim associated whatsoever with the administration of the medicines specified below.

Please list any Medicines your child needs or can be given. Please use the additional box below if extra space is needed

	Describe
Name of Medicine
Strength
How much to give (dose)
Type (liquid, tablet, inhaler)
When to give dose (time)
Any other information

Medication (please use this box to provide extra detail of any medication your child needs)
I authorise the person in charge or their designated deputy to give up to 2 doses of paracetamol of a dosage suitable for the age and weight of my child in a form suitable for my child. I understand that on the administration of the second dose I will be contacted regardless of the time of day or night.*
My child is allergic to the following medicines (please state none if no known allergies). If this box is left blank no medication will be given*
In the event of my daughter / son requiring emergency medical or dental treatment whilst taking part in the Pony Club activity as described above, and an Officer or other responsible adult being unable to contact either myself or other person with a parental responsibility for my daughter / son, I hereby authorise the District Commissioner / Centre Proprietor or other Official of the Pony Club to obtain such medical or dental treatment for my child as they, in their absolute discretion, think necessary after consultation with a medical or dental practitioner. This authority extends to all medical and dental treatment including the giving of an anaesthetic where necessary.

Data provided will be stored and used in line with current data protection regulations.

FINALLY, WHILST EVERY CARE IS TAKEN, THE OFFICIALS OF THE PONY CLUB CANNOT BE HELD RESPONSIBLE FOR ANY LOSS, DAMAGE OR ACCIDENT TO SPECTATORS, MEMBERS, THEIR PONIES OR EQUIPMENT WHILST AT CAMP.
Signature*

Clear
Print name*

First NameLast Name
Role / Relationship to child (e.g. Mother / Father / Legal Guardian)*
NO APPLICATION WILL BE ACCEPTED UNLESS THE SUBSCRIPTION FOR THE CURRENT YEAR HAS BEEN PAID ALONG WITH CAMP FEES

PLEASE SUBMIT THIS FORM AND THEN MAKE CORRECT PAYMENT ONLINE

JUNIOR CAMP FEES: £165.00

Early bird fee £145.00 (if paid before 25th June 2024)

BACS Pament details are (New details)

Sort code - 05-02-00

Account no - 29914573

Account Name - Warwickshire Hunt Pony Club

Please make ref as follows CAMPSURNAME eg CAMPDANCER
Should be Empty:

WHPC JUNIOR Camp Form 2024

Parents help and food rotas

Food Rota

MEDICAL CONSENT FORM