Backpackers Registration

Who We Are
Safeguarding

Who We Are
Safeguarding

Backpackers Children's Registration Form

* Indicates required field

Child's Name *

First

Last

Date of Birth (dd/mm/yyyy) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

GP's Name *

GP's Telephone Number *

Any known allergies or medical conditions *

Parent/Guardian's Name *

First

Last

Paren't/Guardian's Address (if different to child's) *

Line 1

Line 2

City

State

Zip Code

Country

Email *

To keep you updated on other Wave Kids events and activites. Your details won't be shared with anyone else.

Contact Number *

Emergency Contact Number *

I give permission for my child's details to be entered onto the Wave Kids database (information will be kept confidential and won't be shared with third parties) *

Yes No

Days attending Backpackers *

All Monday 2nd August 2021 Tuesday 3rd August 2021 Wednesday 4th August 2021 Thursday 5th August 2021 Friday 6th August 2021

I give permission for my child's picture to be taken during the club (the photos will be used for Wave Kids publicity only, such as on the website and newsletters) *

Yes No

I give permission for my child/ward (named above) to attend the Backpackers holiday club and understand that if they fail to adhere to the club's code of conduct, I may be called to collect my child early. *

Yes

Thank you for completing this form. All information will be stored securley and treated in accordance with the Data Protection Act 1998.

Submit

Who We Are
Safeguarding