Pulsar Weekend Sue Shaw | March 28, 2020 | | No Comments Date/Time Date(s) - 28/03/2020 - 29/03/2020All Day Bookings Price£40.00 Spaces 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Child 1 Full name * Preferred first name Date of birth * School attended School year Planned Secondary School Medical Information If your son/daughter requires a mild painkiller such as Paracetamol or another non-prescription drug e.g. Piriton, are you willing for it to be given by our First Aid Officer? * Yes No Do they suffer from any allergies? * Yes No If yes, please give details Do they have any medical conditions about which we should be aware? (e.g. diabetes, migraine, epilepsy, asthma) * Yes No Details of any medical conditions: Are they taking any medication? * Yes No If yes, please give details Do they have any disability about which we should be aware? * Yes No If yes, please give details Date of last Tetanus injection (if known) Please state any special dietary needs Any other information we should know Child #NUM# Full name * Preferred first name Date of birth * School attended School year Planned Secondary School Medical Information If your son/daughter requires a mild painkiller such as Paracetamol or another non-prescription drug e.g. Piriton, are you willing for it to be given by our First Aid Officer? * Yes No Do they suffer from any allergies? * Yes No If yes, please give details Do they have any medical conditions about which we should be aware? (e.g. diabetes, migraine, epilepsy, asthma) * Yes No Details of any medical conditions: Are they taking any medication? * Yes No If yes, please give details Do they have any disability about which we should be aware? * Yes No If yes, please give details Date of last Tetanus injection (if known) Please state any special dietary needs Any other information we should know Parent / Guardian details Name of parent/guardian * Email * Home phone * Mobile phone * Home address * Postcode * If you will be joining us on Saturday Evening, please tick here (don't select activity options below) * Please rate the following activities 1-4 in order of preference (1 = 1st choice, 2 = 2nd choice etc.) Places for activities will be allocated in the order that the consent forms are received so get your forms in quickly in order to get your first choice. Abseiling * Caving * Crate Stack & Archery * Bush Craft & Low Ropes * Would you like to be notified about future events? * Yes No Parental / Guardian Consent I give permission for my child to take part in the event named above * I consider my son/daughter to be medically fit for this activity and will inform the leader should any of the above information change by the date of the activity. * I give consent for my child to be in a car driven by one of the PSALMS team or a volunteer driver * In an emergency and/or if I cannot be contacted, I am willing for my child to receive the necessary hospital or dental treatment including an anaesthetic * I give my consent for photos and videos to be taken of the young people (including my child) during their time at the event. I understand that these photos may be used in publicity to promote the work of PSALMS. * I give permission for photos/video of my child to be included in Diocese Sports Ministry future publicity, and as part of their social media profile * I give permission for all the personal information provided here to be by PSALMS for up to 5 years at which point new consent forms will be distributed * My son / daughter is able to swim 50 metres unaided: * Contact ben.fudge@psalms.uk.net for more information Transport Arrangements To allow for the smooth running of the weekend, we rely on volunteer parents to assist with transporting the children to Viney Hill on Saturday morning at 8.30am and then returning them from Viney Hill to Minchinhampton Baptist Church on Saturday evening at 5.00pm after they have completed all their activities. Please indicate below if you could assist us with this arrangement and if so, how many you could transport in your car. How many passengers can you take in your car? * To Viney Hill (8.30am Saturday) * From Viney Hill (5.00pm Saturday) * Viney Hill Consent Form must also be completed, have you already completed the form? * Yes I'm just about to Coupon Code I consent to my submitted data being collected and stored as outlined by the site . Log in if you already have an account with us. Username Password Remember Me Lost your password? Related About The Author Sue
