Activity Consent Form

Residential Snowdon Ranger - Snowdon Consent Form
Participant Name

First NameMiddle NameLast Name
Membership Number
The membership was texted to you when you completed the consent form online. Please add this number at the text above and if you dont have one please complete the below link and we will create one for you. https://zsdefenceacademy.co.uk/consent/
Email
example@example.com
Phone Number
Please enter a valid phone number in the format 7720636847 (you do not need to add the 0).
Residential (Indoor accommodation) weekend Dates

Snowdon- 19th, 20th, 21st Sept (max 40 ppl)
Do you have any medical conditions, disability, additional needs and what medication are you currently taking?
Any Food requirements:

VegeterianVeganGluten Free
Type any allergies you may have
Itenirary

Self catering residential and everyone will have light cleaning duties. We will all work together to make this a great expreince. Sisterhood :)

The cost of £115 Per Person includes the full expreince, transport, activities and staying at the residential for 2 nights. Food is not included, please bring your own, saturday evening BBQ is included only in the price

Friday 18th July 25

11am set off - Meeting point: Littleharwood Children Centre, Robinson Street, Blackburn, BB1 5PE (Please do not park your car at the centre as this closes at 6pm and your car could get locked in, park on the main road. Make sure you're on time as we will not be waiting for anyone. We will setting off promptly at 11am)

2pm Reach the residential venue - leave lugage in one room and short local walk, pack sandwhich for lunch as no access to kichen till 4pm

4pm - Settle into rooms

5pm - Tea/Refreshments - Bring your own

6pm - Painting session

7pm Yoga and meditation

8pm Dinner (we will all share the food we have brought) Go through terms/conditions, activites, timing, duties and the plan for the weekend. Please bring a dish each for everyone to share and eat together. Please bring your own plate, cup and cutlery to use as this will not be provided.

9pm Wellbeing session and story telling (optional)

10pm Bedtime

(Prayer time inbetween)
What type of food dish will you bring for Friday 19th Sept 25?
Saturday 20th Sept 25

8.30am - Wake up, bring your breakfast (Please bring your own plate, cup and cutlery to use as this will not be provided) and bag pack ready for a hike

9.30am - Start the Snowdon hike (highest mountain in wales 704 metres) (5-7km) which is led by an experienced qualified mountineer's. The trek will be around 6 hours approximately dependent om experience

9.30am - Short hike to snowdon, mostly flat, 3-4km around 3 hours led by zee.

4pm - Arrive at base and ready for refreshments/biscuits

5pm - Yoga session (optional)

7.30pm - BBQ Food being served

9pm - Girl's pampering session - Face masks, Masage etc

10pm - wellbeing session and story telling

11pm - Bedtime

(prayers in between)
BBQ SAT 20th SEPT 25

Beef Burger & ChipsChicken wings & Chips
Sunday 21st Sept 25

8am - Wake up and prepare your own breakfast (Please bring your own plate, cup and cutlery to use as this will not be provided)

9am - Pack items away and clean the building - Please bring your lugage to the main door

10am - Transport will arrive

1pm - Return back to blackburn drop off point Littleharwood Children Centre, Robinson Street, Blackburn, BB1 5PE

(prayers inbetween)
Snowdon- Please tick the activities you wish to participate in:

5-7km Snowdon Hike 704 metres - approx 6 hours3-4km snowdon short walk - approx 3 hoursYoga & meditationStory tellingPaintingGirl's Pampering SessionWellbeing sessions
BED PLAN

Room for 2 GirlsRoom for 4 GirlsRoom for 6 GirlsRoom for 7 GirlsPlease contact Zee after you've booked if you wish to share with your freinds
Please add emergency name, relationship and contact number. (We have no reception at the venue and only access to emergency services. We will contact upon having an emergency)
I, undersigned, agree with the following statements:

I am the participant and happy to participate in the activity specified above. This venue does not have a reception and no access to internet.I understand that participation in this activity involves the risk of personal injury, due to the physical, mental, and emotional challenges in the activities offered. I will take full responsibility and any participant under 18s - the parent/guardian will take responsibility.I am giving my consent in case of an emergency, and in the event I cannot be reached, medical provider can secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication. Medical providers are authorized to disclose protected health information to the adult in charge and/or any physician or health care provider involved in providing medical care to the participant.No refunds permitted for the residential weekendWith appreciation of the dangers and risks associated with programs and activities including preparations for and transportation to and from the activity, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death or loss that may arise against the organization, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program activity.I will aim to arrive on time for the transport on Friday 19th Sept and will inform the organizer 07720636847 incase of an emergency. I hereby agree for the coach to leave if i do not arrive on time and the £115 Per Person will not be refunded and will be donated to the charity Z's Defence Academy.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear
Individual Kit list (please bring a small Duffell bag and no suitcase allowed)

x2 breakfast (Sat & Sun)

x3 lunch (Fri, Sat, Sun)

x1 dinner (Fri) - Your choice of what to bring

Wear 1 pair warm clothes on friday and bring 1 extra warm pair to trek (top, pants, fleece, x2 socks, x3 underwear)

Bladder water bag or 2 litre bottle (alternative x2 1 litre bottle for the hike)

Walking sticks

Warm down jacket

Wolly hat, gloves

Hiking boots

large bathing towel

Small face towel

Yoga mat

Walking Pants

Small back pack

Waterproof jacket/pants/

Swimwear

Travel size toiletries

Medication/Inhaler/Hayfever tablets

Snacks

Head Torch

Night wear

Slippers/sandles for indoors

Namaz Musalla

Flask or Mug

Plastic plate & cutlery (knife, spoon, fork)

Water bottle 1 litre

Feminine hygiene products

Sun Cream

Sleeping bag

All items will need to fit into a small travel bag and no suitcases will be accepted. you will be sent back home if a suitcase is brought as we hve no space on mini bus to store.

Contact for further information

zsdefenceacademy@gmail.com

07720636847
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Residential Snowdon Ranger - Snowdon Consent Form