Participant/s name *

First Name

Last Name

1st Emergency Contact *

First Name

Last Name

2nd Emergancy Contact *

First Name

Last Name

Participants Doctor *

First Name

Last Name

Have you/your child suffered from any of the following: *

Asthma

Diabetes

Heart condition

Sever headaches

Allergies to medicines

Fits, paintings, blackouts

Any other allergies

None of the above

Do you consent to photographs of the activities appearing on our website and social media pages? *

Yes

No

By clicking the check box below, I, the participant or guardian of the participant declare to accept our Terms & Conditions and understand that the information provided above is used for the purpose of the booking and will be deleted at the completion of the course. *

I agree