Active Schools Spring Into Sport. Catrine P4-7. 6th April
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1. What is your childs name? *
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2. Child date of birth and age. *
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4. Telephone contact number (Mobile and Home) *
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5. Parent / Carer E mail address *
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6. Please identify any medical conditions such as Asthma, diabetes, epilepsy, allergies. (if none, please state) *
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7. Please give full details of any medication being taken, how administerd and by whom. If none, please mark N/A *
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8. Does you child have any additional support needs? If so what and how can the need be best supported. If none, please mark N/A *
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9. Does you child have any allergies? Any dietery requirements? Any other relevent information? If none, please mark N/A *
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10. Emergency Contact Details: Please provide at least one alternative emergency contact number from the one in question 4 as well as relationship to the child and address. *
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11. Does your child have permission to leave the session on their own or will they be collected at the venue? Please inform a staff member at the start of the session if this changes. *
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12. Publicity photographs and video / film may be taken at our events / sessions and used by East Ayrshire Council in printed material and on websites, including East Ayrshire Council social media pages. Do you consent for your child to be included in these?
Please select yes or no
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13. * COVID Information - Please read carefully
DO NOT ATTEND if you or anyone from your household should be isolating based on Scottish Government guidelines.
If you have returned from a holiday destination which is NOT EXEMPT from the UK Government list of quarantine countries, then you should remain in isolation and you/your child should not attend any activity until the period of isolation ends.
Parents/carers who are supervising their children should abide by Scottish Government physical distancing guidance and stay at least 2m away from those out with their own household. Groups of parents from different households should not congregate before, during or after the activity.
Ensure your child washes their hands thoroughly before activity and arrives ready to take part in appropriate clothing.
Ensure your child and Activity Leader has your contact number.
Your child should bring their own water bottle with their name clearly visible.
Please give plenty of notice as to whether your child will be absent from any activity/session.
To limit over-crowding, please bring your child to the activity session on your own, following the facility specific advice.
Parents/carers will be encouraged not to spectate during activities in order to ensure physical distancing measures for adults are maintained. Should this not be adhered to then the activity will be cancelled.
Immediately after activity, a parent/carer should collect the child as promptly as possible, adhering to the facility specific guidance.
Declaration of consent:
- I hereby give consent to my child named above to take part in the activity above.
- I understand that no toilet facilities are available at the session venue.
- I undertake to inform the staff of any changes in the health of my child.
- I understand that in the event of my child requiring medical attention the group leader will make every effort to contact me
- However in an emergency I give permission for the group leader to authorise any necessary medical treatment, including anaesthetic or blood transfusion.
Please Type your full name, relationship to child and todays date. *