Backpackers Registration

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What's On
Get Involved
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Who We Are
What's On
Get Involved
- Volunteering
- Friends of the Wave
Safeguarding
Get in Touch

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
What's On
Get Involved
- Volunteering
- Friends of the Wave
Safeguarding
Get in Touch