Little Explorers Camp Registration Form

Little Explorers Camp Registration Form
Child's Information
Child's Name*

First NameLast Name
Birth Date*

DayMonthYear
Age in July 2024*
Gender*

MaleFemalePrefer not to say
Address*

Street Address

Street Address Line 2

CityCounty

Postal Code
What school or nursery does your child attend?*
Is your child toilet trained?*
Parent/Guardian Information
Name*

First NameLast Name
Mobile Number*
E-mail*
example@example.com
Emergency Information
Primary Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Alt. Phone Number

Area CodePhone Number
Secondary Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number

Area CodePhone Number
Does anyone other than yourself have parental responsibility over your child?*
Full name of additional person with parental responsibility:
Address of additional person with parental responsibility:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number of additional person with parental responsibility:
Please enter a valid phone number.
Which parent/carer does the child normally live with? Please specify.
Medical Information
Does your child suffer from a medical condition?*
Does your child take any regular medication? Please specify clearly below. *
Does your child suffer from any food allergies or intolerances?*
Does your child have any additional requirements? (Physical, emotional or educational). Please include details of EHCP if relevant.*
Photo and Video Permission
Little Explorers Camp may be filmed or photographed to be used for promotional purposes. Do you give permission for your child to be photographed/filmed for use by the camp for promotional purposes.*

Yes (I give permission)No (I do not give permission)
Additional Information
Any other additional information you feel is important to share?*
Select your booking:
My Products
prevnext( X )
Week 1 (5 Days): 29th July - 2nd AugustThis is the price for 5 days at Little Explorers Camp.
£144.00



Week 2 (5 Days): 5th August - 9th AugustThis is the price for 5 days at Little Explorers Camp.
£144.00



Week 3 (4 Days): 12th August - 15th AugustThis is the price for 4 days at Little Explorers Camp.
£120.00



Singular DaysAdd the quantity of individual days you require (excluding full weeks).
£34.00 Quantity



Total

£0.00
If you have selected singular days, please specify which days your child will be attending Little Explorers Camp:

Monday 29th July 2024Tuesday 30th July 2024Wednesday 31st July 2024Thursday 1st August 2024Friday 2nd August 2024Monday 5th August 2024Tuesday 6th August 2024Wednesday 7th August 2024Thursday 8th August 2024Friday 9th August 2024Monday 12th August 2024Tuesday 13th August 2024Wednesday 14th August 2024Thursday 15th August 2024
Informed Consent and Acknowledgement

I, the undersigned, as the parent or legal guardian of the child named above, give consent for my child to participate in all Little Explorers Camp's activites.

I understand that camp activities include outdoor play, crafts, sports, and other recreational activities, which involve inherent risks. I agree that Little Explorers Camp, its staff, and volunteers are not responsible for any injury or illness that may occur, except in cases of gross negligence or willful misconduct.

In the event of a medical emergency, I authorise the camp staff to seek appropriate medical care for my child if I cannot be reached and agree to be responsible for any associated costs.

By ticking the box below, I acknowledge that I have read and agree to this Informed Consent and Acknowledgement.
I have read and agree to this Informed Consent and Acknowledgment.*

Yes
Policies
Little Explorers Camp Safeguarding Policies

https://www.littleexplorerscamp.com/_files/ugd/6e86a3_8c6a7162dc654fbba5706fcb683d9d03.pdf
I have read and agree to the above Little Explorers Camp Safeguarding Policies*

Yes
Little Explorers Camp Procedure and Policies

https://www.littleexplorerscamp.com/_files/ugd/6e86a3_b8aba13ed833412c81fb2a1b510f984d.pdf
I have read and agree to the above Little Explorers Camp Procedure and Policies*

Yes
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date*

DayMonthYear
Date
Signature*

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Little Explorers Camp Registration Form

Child's Information

Medical Information

Photo and Video Permission

Additional Information

Select your booking:

Policies