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ACTIVATE CAMP REGISTRATION

SUPERVISED Camp Registration Form
To be used for ALL individual young people under 18 years when being supervised by ACTIVATE Instructors. Please complete ALL Sections

Young Person Details

Young Person Details*
First
Last
D.O.B.
 
Has a doctor ever diagnosed your child with a heart condition?*


Has your child recently had chest pains during or after exercise?*


Has your child any food allergies?*


Is your child currently receiving treatment or medication for any other condition?*


Has your child broken any bones in the last 6 months?*


Does you child suffer from any bone/joint problems during exercise?*


Does your child suffer from epilepsy or chronic asthma?*


Is your child Diabetic? If yes please comment below*


Has your child undergone any recent surgery?*


Is there any other reason which has not been mentioned that may affect your child if they took part in physical activities?*


Do you wish to avail of the early drop off from 8.30am for an additional €5 per day or €20 for one week?*


I understand that photographs or films may be taken during the camp and may be used in the promotion of the camp. If you wish for your child to be a part of this please tick one of the following*


As the legal Parent/Guardianof the above named children, Please select "YES" below if you have READ, UNDERSTOOD & ACCEPT the information and warnings printed underneath.*


Important Information for Parents/Guardians.
1. I confirm that the above answers are correct, at this point in time, to the best of my knowledge and belief.
2. I will ensure to inform the instructors at once if any of the above changes.
3. I agree that may child will abide by the rules of ACTIVATE and follow staff instructions at all times.

Parent/Guardian Contact Details

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NAME

Further information on people at higher risk from Coronavirus can be accessed on the HSE website

Please take responsibility for your movements, your child’s movements or another person or child that you have with you and do not put others in danger. Please note when entering our premises that we are following all the latest NSAI, HAS and HSE guidelines to ensure all staff and customers are as safe as possible when undertaking activities here at ACTIAVTE during COVID-19 pandemic. Although we have adhered to all the advice given, we cannot ultimately guarantee that you will be entirely COVID-19 safe due to circumstances that may be beyond our control.

It is each individual’s responsibility to play their part.

Consent

I have understood the Conditions of Entry to the Premises and its activities and have explained same to the child/ren for whom I am responsible.*

I agree that I and the child/ren for whom I am responsible will abide by and are bound by all conditions of entry as set out above.*

Privacy Policy*

This field is for validation purposes and should be left unchanged.








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