The Science Centre- Summer Camp

Contact 1 Details

Please provide details for the first point of contact for your child.
Name

First NameLast Name
Relationship
Mobile Number
Email
example@example.com
Contact 2 Details

Please provide details for the second point of contact for your child.
Name

First NameLast Name
Relationship
Mobile Number
Email
example@example.com

Medical Information

It is important that you provide accurate medical information for your child below.
Does your child have any allergies, chronic illness or medical conditions?
If Yes, please provide information about your child's medical conditions below.
Does your child use an inhaler?
If Yes, please explain any instructions below.
Is your child considered to have special educational needs (SEN) or have an educational and health care plan (EHCP) at school?
If Yes, please detail how we can best support your child.

Safeguarding Information

Please complete the questions below accurately so that we can inform all of our staff of your preferences and requirements.
Mode of transportation: At the end of each day, your child will...
Photography: Occasionally we may take photographs of our children for promotional purposes, for example: social media, classroom displays or printed publications. We would really like to showcase the amazing work we do to our local community. I give permission for photographs of my child to be taken.

Food and Lunch
Are there any food allergies that we need to be aware of?
If you answered yes to the question above, please state the food allergies below.

Payment Details

Please ensure to carefully read the information below to complete the booking for your child.
IMPORTANT - PLEASE CHECK YOUR SELECTION
prevnext( X )
Four day camp - £40
£40.00



Tuesday only
£10.00 Quantity



Wednesday only
£10.00 Quantity



Thursday only
£10.00 Quantity



Friday only
£10.00 Quantity



Total

£0.00
Confirmation

I hereby confirm that I have provided accurate information for my child to the best of my knowledge. If your child misses any days, please be aware no refunds will be issued.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature
Should be Empty:

Registration form 2025