Registration Form

Childs First Name (required):

Childs Surname (required):

Childs Date Of Birth:

Age of child (required):

Gender:

School:

Year Group:

Name of parent/guardian:

Email address of parent/guardian (required):

Home phone number:

Mobile phone number:

Work/Emergency Contact Number;

Does your child have any special needs? please give details:

Is your child on any medication? If so, please give details:

I agree to let my child attend Collis Activity Camp. I understand that children are expected to conform to acceptable classroom behavioural patterns and normal disciplines. I have read, understood and accept the terms and conditions of Collis Activity Camp.

Occasionally, Collis Activity Camp will use photos taken at the camp for the Collis Activity Camp website. Please tick the relevant box to indicate if you do/do not give your consent for your child to be photographed for this purpose.
I consent to my child being photographed for marketing purposesI do not consent to my child being photographed for marketing purposes