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 HALF TERM CAMP:
Tue 1 JuneWed 2 JuneThur 3 June

Please indicate the dates you wish to book for SUMMER CAMP:
Mon 26 JulyTue 27 JulyWed 28 JulyThur 29 JulyFri 30 July
Mon 2 AugTue 3 AugWed 4 AugThur 5 AugFri 6 Aug
Mon 9 AugTue 10 AugWed 11 AugThur 12 AugFri 13 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.