Child's Name (required)

Date of Birth (required)

Parent's Name (required)

Email (required)

Medical (allergies / injuries) (required)

Other (behavioural / SEND) (required)

Emergency Contact 1 (Name and Phone) (required)

Emergency Contact 2 (Name and Phone)

**Optional - Request to be with Friends (Please name up to two friends you wish to be in a group with)

Please indicate the dates you wish to book for Gym Camp:

SUMMER CAMP:
Mon 25th JulyTue 26th JulyWed 27th JulyThur 28th JulyFri 29th July
Mon 1st AugTue 2nd AugWed 3rd AugThur 4th AugFri 5th Aug
Mon 8th AugTue 9th AugWed 10th AugThur 11th AugFri 12th Aug

I hereby give my permission for the qualified coaches employed by Woodstock Gymnastics Club to act in loco-parentis in the event of an emergency.