HAF Southwark

Dynamic Coaching Inclusive Multi-Sports Winter HAF Programme
The Dynamic Coaching Inclusive Multi-Sports Winter HAF Programme offers an engaging, high-quality program tailored for young people to enjoy diverse activities, mixed games, and team sports. Led by expert coaches and designed to inspire and support, this program includes enriching activities, interactive games, and guidance on healthy eating.

Programme Highlights:

High-quality, well-planned sports activities and games
Professional coaching staff to ensure a safe, inclusive environment
Enrichment sessions that foster learning, teamwork, and positive role models
Healthy eating sessions to promote nutrition awareness

PAID SPACES ONLY

Eligibility for Free Places: Children and young people eligible for benefit-related Free School Meals or with refugee status can participate at no cost.

If you are entitled to benefit related free schools meals you can book a place for free Please use the link below:

https://eequ.org/experience/9802

VENUE - PLEASE TICK THE VENUE YOU WISH YOUR CHILD TO ATTEND:*

St Clement with St Peter, East Dulwich

Childs Name:

First NameLast Name

Date of Birth *

MonthDayYear

Gender:*

School Year Group:*

Name of School:*

Primary or Secondary School:*

Ethnicity:*

Siblings Name (if also booking on):

First NameLast Name

Date of Birth (sibling)

MonthDayYear

Gender (sibling):

School Year Group(sibling):

Name of School (Sibling):

Primary or Secondary School (Sibling):

Ethnicity (sibling):

Siblings Name (if also booking on):

First NameLast Name

Date of Birth (sibling)

MonthDayYear

Gender (sibling):

School Year Group(sibling):

Name of School (Sibling):

Primary or Secondary School (Sibling):

Ethnicity (sibling):

Home Address*

Street Address

Street Address Line 2

Post code .

PARENT/GUARDIAN INFORMATION

Parent/Guardian*

First NameLast Name

Mobile Number:*

E-mail address*

example@example.com

EMERGENCY INFORMATION

Emergency Contact's Name*

First NameLast Name

Mobile Number:*

Relationship

Does your child/young person receive benefit related Free School Meals and entitled to Pupil Premium (this is required along with *proof of eligibility)*

YesNo

Does your child / young person have an Education and Health Care Plan at school?*

YesNo

MEDICAL INFORMATION

Does your child/young person have any Special Educational needs and/or disabilities - Please note this camp is not a SEND camp and we will not be able to offer 1-1 support.*

YesNo

If yes, please specify to ensure we can provide the support your child needs:

Does your child have any type of allergy including food allergies, a chronic illness/disability or have any other medical conditions?*

YesNo

If yes - please inform us what the allergy is and what to look out for eg, early signs of a reaction and how severe the allergy is, please also let us know about any chronic illness:

Is your child a vegetarian*

YesNo

Does your child carry an Epi pen?*

YesNo

If yes do you give permission for one of the coaches to administer an EpiPen if needed?*

YesNo

Do you give consent for Dynamic Coaching/Southwark Council to use your child's photograph or video on websites/social media channels*

YesNo

In order for Dynamic Coaching/Southwark Council to comply with privacy regulations, we will need you to give consent to enable us to contact you regarding our free camps via the information provided in this form;*

YES I consentNO I do not consent

Signature*

PAID SPACES (10am - 2pm):

Block Booking of 4 days - 27th,30th December,2nd,3rd January

£65.00

Single Day bookings (10am - 2pm)

£15.00

	Quantity	Price
Friday 27th Dec		£15.00
Monday 30th Dec		£15.00
Thursday 2nd January		£15.00
Friday 3rd January		£15.00

Total

£0.00

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Dynamic Coaching Holiday, Activities & Food (HAF) Winter Activity Camp