Get OWT! Booking form

1
Parent/Carer's Name* This field is required.(if an additional adult will be attending with your child/ren you will need to fill in an additional booking form for them as we have limited numbers of adults allowed to attend.)
First Name
Last Name
2
Email address* This field is required.
example@example.com
3
Mobile phone number* This field is required.
4
Address
Street Address
Street Address Line 2
Town
Post Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Please select which session you would like to attend (you will need to select the date you'd like to attend from the calendar on the left - either Monday or Thursday - and then click the button on the panel on the right to book in. You will not be able to book a session if it is already full.)* This field is required.
6
How many children will be attending with you?* This field is required.
7
Names & Ages of all children attending* This field is required.
8
Places are allocated on a first come, first served basis.

We ask that you let us know as soon as possible if you cannot attend, so that your place can be passed on to someone else.

We are asking for a donation of £2 per family which you can bring with you to help us cover the cost of the activity packs.

Please do not attend the session if any member of your household is experiencing symptoms of COVID-19 or has done in the past 14 days.

If you develop COVID-19 symptoms after attending the group, please let us know as soon as possible by emailing...

June on jl@southwellbaptistchurch.co.uk if you attended Monday's group

Katie on families4smc@gmail.com if you attended Thursday's group

We are sorry that we cannot accomodate children aged 5+ due to the current restrictions.
9
Please tick the box if you or a member of your household has experienced any of the following in the last 14 days...Please be advised that for the safety of everyone at the group you should not attend the Field Farm visits if you need to tick any of the boxes below - we will contact you prior to the group on the number provided to discuss this with you.
a high temperature
a new, continuous cough
loss or change to your sense of smell or taste
Has received a positive COVID-19 test or is awaiting results from a test
10
Are you happy for us to take photos/video of you/your child/ren to use on our facebook/web pages to promote our events?
YESNO
11
Are you happy for us to take photos of you/your child/ren to send to the local press?
YESNO
12
Signature* This field is required.Please sign to confirm you have read and agree to the above.
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