Raised Green eco playgroup booking form.
If you need to get in contact please email raisedgreen@hotmail.com or call 07495027348. I am looking forward to seeing you at my sessions.
Name
First Name
Last Name
Childs Name (1)
First Name
Last Name
Childs Age (1)
Childs Name (2)
First Name
Last Name
Childs Age (2)
Childs Name 3
First Name
Last Name
Childs Age (3)
Relationship to child/ren
Is your child/ren walking?
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency contact details (name and phone number)
Any allergies or health issues? If yes, please give details
Dietary requirements/preferences?
Which date are you booking for? (Can book more than one session)
Thursday 14th November 10:15 - 11:45
Thursday 21st November 10:15- 11:45
Thursday 28th November 10:15 - 11:45
Friday 15th November 13:00- 14:30
Friday 22nd November 13:00- 14:30
Friday 29th November 13:00- 14:30
Is this your first booking?
Yes
No
Please choose which options you will be paying for?
1 - 7 years = £7
0 - 1 year = £4
Additional child = £1.50
Additional adult = £1
Please make payment via bank transfer to:- Raised Green 04-03-33 61412825 (put your surname and the session date as reference)
I confirm I will make payment ASAP to confirm my place. I understand I will be denied entrance to the session if I do not make payment.
Do you give permission for photos on social media? Please also be mindful when taking photos that other children are not in them without prior permission from their parents. Children's face will always be covered by myself when used on social media.
Yes I give permission for photos of my child/ren to be taken and used on social media for promotional purposes
No I do not give permission for photos of my child/ren to be taken.
How did you hear about Raised Green?
Raised_green_kids Instagram
Lauren Coleman Facebook
Flyers
Word of mouth
Other
Raised Green Eco playgroup is a stay & play group with a different environmental theme/issue every month. Most activities will be based around this theme and there may also be seasonal activities. Activities include gardening, messy/sensory play, crafts, printables, book area, baby area and a mud kitchen/potion play. There will a story at the start and end of each session based around the theme, children are welcome to liaten but do not worry if they do not want to. Hot drinks are available for parents however, please take care when drinking these and try to keep them out of children's reach. Breast and bottle feeding are welcome during the session. Plesse supervise your children at all times, this remains your responsibility. Messy play will include taste safe things like cocoa mud and playdough may contain essential oils which are not recommended for children under the age of 3 months and those with skin issues. Risk assessments have been completed however it is your responsibility as parents/carers to fully supervise your children.
I understand and agree to the above advice and accept that i am fully responsible for the children in my care and will supervise them at all times.
I am happy with Raised Green storing my information on this form for safety purposes and in line with Raised Greens privacy policy and data protection laws.
There will be free hot drinks (coffee/tea/fruit and herbal tea) for adults. Please indicate if you are able to bring a reusable cup (there will be a limited amount available for anyone who is not able to bring their own).
Yes
No
Submit
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