Christmas Tennis Camps
OFFICE USE ONLY APPLICATION NUMBER: DATE RECEIVED: PAYMENT RECEIVED: £
Christmas Tennis Camps
Cash Cheque
Application and Consent Form 2016
Credit Card
Thursday December 22 & Friday December 23 9.30am-4.00pm (Early drop-off and/or late pick-up available) If you require early drop-off or late pick-up, please e-mail [email protected] and pay these fees separately on the day of the camp. Cheques payable to ‘University of Essex’.
Contact Information First Child
Second Child
Third Child
Child’s Full Name Date of Birth Gender Home Address Coordinator Position ref if replacement position: Postcode Name of Parent/Guardian Parent e-mail Address Emergency Contact 1 (Please provide details of Parent/Guardian)
Print Name: Relationship to Child: Emergency Number
Print Name: Relationship to Child: Emergency Contact Number y Contact 2
Print Name: Relationship to Child: Emergency Contact Number y
Emergency Contact 2
Print Name: Relationship to Child: Emergency Number
Print Name: Relationship to Child: Emergency Contact Number y Contact 2
Print Name: Relationship to Child: Emergency Contact Number y
Does the participant have any medical conditions we should be aware of?
Yes No If yes, please specify, and talk to staff on the day
Yes No If yes, please specify, and talk to staff on the day
Yes No If yes, please specify, and talk to staff on the day
Do you give permission for photographs to be taken for promotional purposes? Yes
No
*Please tick if you DO NOT wish to receive any marketing material Please state where you heard about the Tennis Camps?
The information supplied on this form will be kept secure and accurate and will only be disclosed to other staff members if necessary in accordance with the University’s registration under the Data Protection Act 1998
Christmas Tennis Camps Pricing and Booking 2016 Please tick date(s) required Day Thursday 22 December (9.30-4.00) Friday 23 December (9.30-4.00)
Member Student
Price £20.00 £22.50 £25.00
Staff Public Student Staff Public
Method of Payment
Cash
Cheque
Children (Please Tick ) Tick () 3 1 2 1 1
2 2
3
£20.00
1
2
3
£22.50
1
2
3
£25.00
1
2
3
Credit Card
3
Total Payment
£l Payment
Terms and Conditions CONDUCT 1. Camps are run at the University of Essex Sports Centre and children enrolled are under our care – therefore they must abide by the Code of Conduct which can be found at the Sports Centre. Any serious breach of these rules will lead to exclusion from the camp without refund. HEALTH AND SAFETY 2. A qualified First Aider will be on site at all times throughout the duration of the Camp. 3. In the case of emergency, the First Aider will take appropriate action and contact the parent/guardian directly. 4. It is accepted by the parent/guardian that when taking part in sports there may be injuries. The Sports Centre will be sure to take the appropriate steps and measures to make activities safe, but this is sometimes beyond our control 5. All lead instructors are DBS checked, with all student instructors vetted and interviewed POLICIES 6. Places will be reserved on a first come, first served basis 7. Refunds will not be given for cancellations within 48 hours of the Camp 8. We reserve the right to cancel the Camp up to 72 hours prior to the start, due to a lack of numbers making the session non-viable 9. We reserve the right to refuse acceptance for applicants to the Camp. GENERAL 10. Please supply a packed lunch and a water bottle for your child(ren). Catering is not available on-site. 11. Please ensure your child (ren) is wearing appropriate warm clothing for this time of the year. Whilst children will have an active day, the temperature of the bubble will be the same ambient temperature as outside, but without the wind chill. 12. Please arrive within good time for the start of the day activities. If for some reason parents are late for collection, the children will be waiting in the reception area or on the balcony.
TERMS & CONDITIONS I confirm that I have answered the above questions to the best of my ability and hereby declare that my child will be using the University Sports Centre of their own free will. I understand that payment is non-transferable and non-refundable unless of insufficient numbers to run the Camp Signature of Parent/Guardian/Participant Date
Position ref if replacement position:
Christmas Tennis Camps
Cash Cheque
Application and Consent Form 2016
Credit Card
Thursday December 22 & Friday December 23 9.30am-4.00pm (Early drop-off and/or late pick-up available) If you require early drop-off or late pick-up, please e-mail [email protected] and pay these fees separately on the day of the camp. Cheques payable to ‘University of Essex’.
Contact Information First Child
Second Child
Third Child
Child’s Full Name Date of Birth Gender Home Address Coordinator Position ref if replacement position: Postcode Name of Parent/Guardian Parent e-mail Address Emergency Contact 1 (Please provide details of Parent/Guardian)
Print Name: Relationship to Child: Emergency Number
Print Name: Relationship to Child: Emergency Contact Number y Contact 2
Print Name: Relationship to Child: Emergency Contact Number y
Emergency Contact 2
Print Name: Relationship to Child: Emergency Number
Print Name: Relationship to Child: Emergency Contact Number y Contact 2
Print Name: Relationship to Child: Emergency Contact Number y
Does the participant have any medical conditions we should be aware of?
Yes No If yes, please specify, and talk to staff on the day
Yes No If yes, please specify, and talk to staff on the day
Yes No If yes, please specify, and talk to staff on the day
Do you give permission for photographs to be taken for promotional purposes? Yes
No
*Please tick if you DO NOT wish to receive any marketing material Please state where you heard about the Tennis Camps?
The information supplied on this form will be kept secure and accurate and will only be disclosed to other staff members if necessary in accordance with the University’s registration under the Data Protection Act 1998
Christmas Tennis Camps Pricing and Booking 2016 Please tick date(s) required Day Thursday 22 December (9.30-4.00) Friday 23 December (9.30-4.00)
Member Student
Price £20.00 £22.50 £25.00
Staff Public Student Staff Public
Method of Payment
Cash
Cheque
Children (Please Tick ) Tick () 3 1 2 1 1
2 2
3
£20.00
1
2
3
£22.50
1
2
3
£25.00
1
2
3
Credit Card
3
Total Payment
£l Payment
Terms and Conditions CONDUCT 1. Camps are run at the University of Essex Sports Centre and children enrolled are under our care – therefore they must abide by the Code of Conduct which can be found at the Sports Centre. Any serious breach of these rules will lead to exclusion from the camp without refund. HEALTH AND SAFETY 2. A qualified First Aider will be on site at all times throughout the duration of the Camp. 3. In the case of emergency, the First Aider will take appropriate action and contact the parent/guardian directly. 4. It is accepted by the parent/guardian that when taking part in sports there may be injuries. The Sports Centre will be sure to take the appropriate steps and measures to make activities safe, but this is sometimes beyond our control 5. All lead instructors are DBS checked, with all student instructors vetted and interviewed POLICIES 6. Places will be reserved on a first come, first served basis 7. Refunds will not be given for cancellations within 48 hours of the Camp 8. We reserve the right to cancel the Camp up to 72 hours prior to the start, due to a lack of numbers making the session non-viable 9. We reserve the right to refuse acceptance for applicants to the Camp. GENERAL 10. Please supply a packed lunch and a water bottle for your child(ren). Catering is not available on-site. 11. Please ensure your child (ren) is wearing appropriate warm clothing for this time of the year. Whilst children will have an active day, the temperature of the bubble will be the same ambient temperature as outside, but without the wind chill. 12. Please arrive within good time for the start of the day activities. If for some reason parents are late for collection, the children will be waiting in the reception area or on the balcony.
TERMS & CONDITIONS I confirm that I have answered the above questions to the best of my ability and hereby declare that my child will be using the University Sports Centre of their own free will. I understand that payment is non-transferable and non-refundable unless of insufficient numbers to run the Camp Signature of Parent/Guardian/Participant Date
Position ref if replacement position:
