October 2026 - Street-WYze Camp Sign up

1

Camp location* This field is required.You can select multiple answers

Westmoor (8:30 - 16:30)

St John's CofE Primary - Brighouse (8:30 - 16:30)

2

Please make us aware if there are any days during the week that your Child(ren) can't attend

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Email Address* This field is required.

4

Your Full Name* This field is required.

First Name

Last Name

5

Child's Full Name* This field is required.

First Name

Last Name

6

Childs Date of Birth* This field is required.

Date

7

First line of address* This field is required.

8

Postcode* This field is required.

9

Emergency Contact Number* This field is required.

10

What school do they attend* This field is required.

11

Allergies, Illnesses or SEN needs

12

Does your child need to take any medication during the camp?* This field is required.Please note: If your child requires medication, they must bring their own medication with them, including EpiPens.

YESNO

13

What medication is required and how frequently does it needs to be taken?* This field is required.

14

Do you give permission for your child to be photographed or filmed during camp activities?* This field is required.

YESNO

15

Do you want to add another child?* This field is required.

Yes

No

16

Second Child's Full Name* This field is required.

First Name

Last Name

17

Second Child's Date of Birth* This field is required.

Date

18

Same address as the first child?* This field is required.

Yes

No

19

First line of address* This field is required.

20

Postcode* This field is required.

21

Is this the same emergency contact number as previously provided?* This field is required.

Yes

No

22

Emergency Contact Number* This field is required.

23

What school do they attend* This field is required.

24

Allergies, Illnesses or SEN needs

25

Does your child need to take any medication during the camp?* This field is required.Please note: If your child requires medication, they must bring their own medication with them, including EpiPens.

YESNO

26

What medication is required and how frequently does it needs to be taken?* This field is required.

27

Do you give permission for your child to be photographed or filmed during camp activities?* This field is required.

YESNO

28

Do you want to add another child?* This field is required.

Yes

No

29

Third Child's Full Name* This field is required.

First Name

Last Name

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Third Child's Date of Birth* This field is required.

Date

31

Is this the same address as previously provided?* This field is required.

Yes

No

32

First line of address* This field is required.

33

Postcode* This field is required.

34

Is this the same emergency contact number as previously provided?* This field is required.

Yes

No

35

Emergency Contact Number* This field is required.

36

What school do they attend* This field is required.

37

Allergies, Illnesses or SEN needs

38

Does your child need to take any medication during the camp?* This field is required.Please note: If your child requires medication, they must bring their own medication with them, including EpiPens.

YESNO

39

What medication is required and how frequently does it needs to be taken?* This field is required.

40

Do you give permission for your child to be photographed or filmed during camp activities?* This field is required.

YESNO

41

Are you happy for us to keep your information to contact you about future camps* This field is required.

YESNO

42

How would you like to pay?* This field is required.

Childcare Vouchers

Bank Transfer

43

Do you wish to provide us with anymore information?