Half-term Holiday Camp (sample)

One form for each child, please. Fields marked * are required. Sending this form does not guarantee a place, we will contact you to confirm.

You are booking for the camp shown at the top of this page.

About the young person

Holiday Activities and Food (HAF)

Which days would you like a place on? * (tick every day that applies)Mon 16 Nov 2026, 9:30am to 3pmTue 17 Nov 2026, 9:30am to 3pmWed 18 Nov 2026, 9:30am to 3pmThu 19 Nov 2026, 9:30am to 3pmFri 20 Nov 2026, 9:30am to 3pm

Monitoring (optional)

Funders ask us to show who we reach. This is optional and you can choose “Prefer not to say”.

Home address

Parent or carer

Do you have parental responsibility? *YesNo (please explain in notes)

Emergency contacts

Someone we can call if we cannot reach you. Please give two people if you can.

Health, allergies and additional needs

This helps us keep your child safe and make sessions work for them. It is kept private and only seen by staff who need it.

Does your child have any allergies? *YesNo

Disability, additional needs or SEND (tick all that apply)AutismADHDLearning difficultySpeech, language or communication needsPhysical disabilitySensory needs (sight, hearing, sensory processing)Mental health needsOtherNone

Does your child have an EHCP or SEN support plan at school?YesNoNot sure

Permissions

How will your child get home? *Collected by an adultWalks home with friends or siblingsWalks home alone

Photos *Yes, photos may be used on our website and social mediaPhotos for internal records onlyNo photos of my child

I give permission for staff to get emergency medical treatment for my child if I cannot be reached.

I agree that Winnr Sport CIC may store the information on this form, including health and additional needs information, to run sessions and keep my child safe. I have read the privacy notice.

I have talked to my child about the session rules and behaviour expectations.