Velocity Bookings

Velocity Sports Camp

October Sports Camp 2024
Child's Name*

First NameLast Name
Child's Year Group*
Please list any medical/behavioural needs
CHILD 1 DAYS

Tuesday 29th October 2024Wednesday 30th October 2024Thursday 31st October 2024
Child 2 Name:

First NameLast Name
Child 2 Year Group
Child 2 medical/behavioural needs
CHILD 2 Days

Tuesday 29th October 2024Wednesday 30th October 2024Thursday 31st October 2024
Contact Information

Please provide contact information for booking confirmation and as an Emergency Contact
Parent/Guardian Name:*

First NameLast Name
Email*
example@example.com
Contact Number*
Contact Phone Number
Emergency Contact 2

In the first instance the Primary Contact Information above will be used. Please provide an additional emergency contact in the event that the primary contact is not reachable
Emergency Contact 2*

First NameLast Name
Emergency Contact 2 Phone Number*
Permissions/Consent/Declarations
- I give consent for the Camp Leader to authorise emergency medical treatment, including anaesthetic & blood transfusion should it be necessary.
- I will inform Velocity Primary Services should any details on this form change or any medical changes arise.
- I give permission for my son / daughter / ward to take part in the activities during the sports/dance camp. I understand that every care will be taken to ensure the safety and welfare of my child and that there is an element of risk involved.
- I accept that in the event of my child behaving in a way that adversely affects the safety of an activity, child or an adult, the camp leaders reserve the right to ask for them to be collected with no refund offered.
- I declare that I am the parent / legal guardian of the child(ren) named in this form and that the information on this form is correct to the best of my knowledge.
I agree with/consent to the above statements
Photo Permission*
permission for my images/videos of my son/daughter/ward to appear on the Velocity Primary Services website, social media pages or on advertisements/publications promoting the work of Velocity Primary Services either individually or as part of a group. Child information will not be displayed with pictures/videos. Velocity Primary Services recognise the need to ensure the welfare and safety of all young people in sport.
DATA

Velocity Primary Services values your privacy. Your data will only be used to contact you regarding camps and Velocity Primary Services will not share your submitted data with any 3rd parties (with the exception of medical emergencies and child protection issues) By ticking this box you consent to us holding your data. By withdrawing your submitted data during the Velocity Holiday Camp you may forfeit your place on camp. You can request to see the information we hold on you at any time or if you wish to withdraw consent you can contact us at data@velocityprimaryservices.co.uk
I agree to the above date/privacy notice
Signed Parent/Guardian*

Clear
Should be Empty:

Velocity Sports Camp

Contact Information

Emergency Contact 2