Broomley HAF Consent Form

Broomley HAF Consent Form

We are now pleased to be able to offer our Broomley HAF Provision

When: Monday to Thursday start w/c 4th August 10-2pm daily

Where: Broomley Grange, Stocksfield. NE43 7RX

Cost: Free for Children on Benefit Related Free School Meals, paid places are available.

Free Transport is available from Prudhoe and Hexham.

Includes lots of fantastic activities from water slides to assault courses, rounders, archery, messy play, arts and crafts, cooking and much much more.

To sign up please fill out the form below and someone from AF will be in touch to confirm your booking.

Includes a free hot meal and healthy snacks throughout the day.

Child's Name

First Name

Last Name

Child's Date of Birth

PLEASE NOTE AMERICAN SYSTEM SO MONTH FIRST AND DATE SECOND.

YYYY

How did you hear about us?

Parent/Carer Details

Parents Name

Parent's Mobile Number

Parent's Email

School they attend

Medical & Emergency Details

Please provide contact details to those provided above incase we are unable to reach you

Any Medical Conditions, Allergies or Special Needs

Any medication

Emergency Contact Relationship

Emergency Contact Name

First Name

Last Name

Emergency Contact Mobile Number

(###)

###

####

Signature

Data Protection: Here at Active Future we take your privacy seriously and will only use your personal information to administer your account and to provide the products and services you have requested from us. Please click below for our full Privacy Policy. www.activefuture.info/privacypolicy However, from time to time we would like to contact you with details of other events and offers and with information such as newsletters and company updates. We will never pass your details on to any 3rd parties for marketing purposes. We may also, from time to time take photographs for marketing purposes, by ticking the box below you are providing your consent for us to do so. Safeguarding: It is your responsibility to ensure your child is dropped off and collected safely by a parent or guardian from the coach at any of our events (Sessions/Holiday Weeks etc), we will do our upmost to ensure this.

CONSENT

From time to time we may take photos and videos to show you what we have been doing or run live sessions. These may be shared on social media.

I Consent

I Do Not Consent

Confirm you are on benefit related free school meals

Which week would you like to attend?

You can tick as many as you wish

Week 1 (4th August)

Week 2 (11th August

Week 3 (18th August)

Week 4 (25th August)

Do you Need Transport?

We collect from either Prudhoe or Hexham

Yes

Broomley HAF Consent Form

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