Budehave
n
Co m m u n i
ty
Leisure
May Half
Term
Holiday A
ctivities
Contact | Liam Dart: 07974 348 468, Rob Francis: 07813198692, Budehaven Community Leisure: 01288 353714
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3
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TUES
Activity
up
Age Gro
Time
Cost
Tumble Tots
1 - 7 Years
10am - 12pm
Ball Sports
Handball,
Volley ball &
Bench ball
7 - 12 Years
9.30am - 12pm
£5
Kangaroo Kids
Ball & Racket
Sports
Handball,
Dodge ball &
Bench ball.
Tennis,
Badminton &
Squash
3 - 7 Years
1pm - 4pm
£5
Racket Sports
Tennis,
Badminton &
Squash
8 - 12 Years
1pm - 3pm
Select
£2.20
£3
Please Ensure You Complete Both Sides Of This Form
http://www.budehaven.cornwall.sch.uk/community-leisure
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wedS
Activity
up
Age Gro
Activity Day
A range of activities
sports, dance, arts &
crafts, plus a nature
trail. Children will
be divided into age
groups.
4 - 14 Years
Time
Cost
Half day
8.30am - 12.30pm
or
12.30pm - 5.30pm
£12
Whole day
8.30am - 5.30pm
£20
Select
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thurS' 2
Kangaroo Kids
Art & Crafts
3 - 7 Years
10am - 12pm
£6
Art & Crafts
8 - 12 Years
10am - 12pm
£6
12.30pm - 5pm
£5
A Variety Of
Sports
Ultimate Frisbee, 3 - 13 Years
Dodge Ball, Crazy
Catch, football
**If your child is booked on all day make sure they have a drink and healthy packed lunch. All activities unless stated are at
Budehaven Community Leisure. Please make cheques payable to: Budehaven Community School.
The bookings will not be confirmed until we have received the completed booking form and payment.
All bookings should be sent DIRECTLY to:
LIAM DART/ROB FRANCIS, BUDEHAVEN LEISURE CENTRE, STRATTON ROAD, BUDE, and CORNWALL, EX23 8AW.
FOR QUERIES PLEASE CONTACT: LIAM DART: 07974 348 468 ROB FRANCIS: 07813198692 LEISURE CENTRE: 01288 353714
EMAIL [email protected]
Please be aware that if there are insufficient numbers booked on for sessions we will have to cancel sessions.
Booking Form
Child’s Name:
School Year 2015/2016 : (Please Circle)
D.o.B:
R 1
2
3
4
5
6
7
8
Age:
9
Home Address:
Postcode:
School Attending:
E Mail Address:
Telephone – Please provide at least 2 numbers in priority order:
Number
1
2
3
Who (name & work/home/mob)
MEDICAL INFORMATION & CONSENT
Medical conditions / allergies: (i.e. asthma, diabetes)
Medication / special requirements ( please attach a further sheet if required):
I hereby authorise the appropriate activity staff member to administer the following medication to my
child.
Medication times and dose:
By signing this sheet you are consenting to the details provided in this sheet.
I hereby give consent for my child to receive hospital / medical treatment should the need arise.
(Please see statement below)
I consent to any emergency treatment necessary. I therefore authorise the appropriate activity staff
member to sign on my behalf. Any written form of consent required by the hospital authorities should
medical treatment be deemed necessary, provided that the delay required to obtain my signature might
be considered, in the opinion of the doctor or surgeon, likely to endanger my child’s health or safety.
Has your child any additional needs:
Will there be a personal assistant attending with your child?
Does your child need an assistant to work with them on a 1-1 basis?
YES
YES
NO
NO
PHOTOGRAPHS / VIDEO & CONSENT
I am happy for my children to be photographed and/or videoed when participating in holiday programme
activities. (Photos/video may be used to publicise the programme in print or on the web). YES
NO
Parent’s Signature:
Print name:
Relationship to child:
Date:
COLLECTION DETAILS
We are concerned for your child’s safety and for peace of mind have taken the following measures.
• My child will be picked up by:
Relationship to child
• My child will not be picked up (e.g. walking/cycling)
Should you wish your child to leave without being picked up please send a note with your child to explain
this.
Please Note: By signing any of the above you are confirming that you have parental consent for the child
mentioned above.