Registration

If you’re interested in your child attending Camp please complete the registration form below. The total fee is £150. You need to submit your online registration along with a deposit of £60 to your local youth club before 31st May 2020 to book a place.

Please fill out the form below to register.

* indicates required field

Your Name:*

Email:*

Please select the location of the youth club your child attends:*

Please Select Aberkenfig Barry Cardiff Mountain Ash Other

Name of Child:*

Child's Gender:*

Please Select Male Female

Date of Birth:*

Age at Camp*

School year in September 2020*

Address (including postcode):*

Name of Parent/Carer:*

Contact Address (If different from above):

Daytime Telephone:

Evening Telephone:

Mobile Telephone:

Emergency Contact Name:*

Relationship to the child:*

Emergency Contact Telephone Number:*

Emergency Contact Address (including postcode):*

Name of GP:*

GP's Telephone Number:*

GP's Address:*

Date of Last Anti Tetanus Injection:*

Does Your Child Have Any Illness/Disability:*

Please Select Yes No

Details of Any Illness/Disability:

Will Your Child Be On Any Medications At The Time Of Camp:*

Please Select Yes No

Details of any medication required during the camp (all medication must be labelled correctly and clearly with name and dose needed each day):

Does Your Child Have Any Allergies (for example, to Face Paints):*

Please Select Yes No

Details of any allergies:

Does Your Child Have Any Special Dietary Requirements:

Please Select Yes No

Details of any special dietary requirements:

Travel arrangements

Would you like to book a seat on the coach to Camp?*

Please Select Yes No, I will transport my child myself

Please Note: All children will be brought home by coach.

Consent regarding Camp activities:

Listed below are activities undertaken at Camp that require consent.

Please read the details below, and those listed below the form, and then choose "I Consent" to give your consent.

Any exclusions can be listed in the space below, however, please note that should you list activities here your child will be unable to join in that activity for the duration of the week.

Health Care:

In an emergency and/or if I am not contactable, I am willing to permit Doctor / hospital or dental treatment including an anaesthetic. I am also willing to permit any First Aid treatment as may be deemed necessary by a qualified First Aider.

Outings:

During Camp, visits may be made to local beaches, dunes and woodland areas and other places of interest.

Swimming:

There is shallow pool on the beach which is mostly suitable only for splashing about in. The children have great fun in this pool, which is supervised by Camp Staff positioned around it. The depth of the water is checked each time we use it.

We do not allow sea swimming from the beach closest to St Madoc's. If we are to take the children sea swimming, it will only be from a beach where official Lifeguards are present.

Please note on the registration form if your child is unable to swim or needs careful monitoring.

Details of any regular medication, medical problem (e.g. asthma, epilepsy, diabetes, allergies, dietary needs, etc.) or disability which may affect the swimming activity need to be completed in the health section of the registration form (above).

Swimming:*

Please Select Can't swim Swims comfortably in a swimming pool Swims comfortably in open water

Swimming comments (if required):

During a typical week of camp your child may be involved in any of the following:

• Sea activities (which may include games on the water margin),
• Dodge ball,
• General activities,
• Transport (such as outings and swimming),
• Photographs/Videos taken for use during Camp and afterwards in Camp promotion.

This list is representative of the types of activities campers engage in but is not exhaustive. Your child may be involved in other activities of a similar nature to those outlined on this list.

I confirm that my child is in good health and I consider him/her fit to participate in the activities above and consent to him/her doing so. I give consent for the child named on this form to receive health care and first aid as outlined on this form.

Consent:*

Please Select I Consent

Any Exceptions:

By submitting this form I confirm that I have read and understood the content above and below, and that, to the best of my knowledge, the details I have provided are both correct and accurate.*

Please Select I Agree

CAPTCHA Code:*

Further Details About Items For Consent

Outings
During Camp, visits may be made to local beaches, dunes and woodland areas and other places of interest.

Swimming

There is shallow pool on the beach which is mostly suitable only for splashing about in. The children have great fun in this pool, which is supervised by Camp Staff positioned around it. The depth of the water is checked each time we use it.

We do not allow sea swimming from the beach closest to St Madocs. If we are to take the children sea swimming, it will only be from a beach where official Lifeguards are present.

Please note on the registration form if your child is unable to swim or needs careful monitoring.

Details of any regular medication, medical problem (e.g. asthma, epilepsy, diabetes, allergies, dietary needs, etc.) or disability which may affect the swimming activity need to be completed in the health section of the registration form (above).

Camp Activities
There are various normal activities/sports taking place on site such as football, dodge ball, sports in the sports hall etc. which, whilst taking place with leaders nearby, are not explicitly monitored. These are just normal children’s activities which have functioned successfully like this for many years. Children are always monitored closely when taken off site such as for organised activities on the beach.

While involved in the ranges of activities the children will be under the control and care of the group leader and/or other adults approved by the church/organisation leadership. While the staff in charge of the group will take all reasonable care of the children, they cannot necessarily be held responsible for any loss, damage or injury suffered by any child during, or as a result of, an activity

Transporting Children
Camp is able to provide transport for children to and from their home towns and for specific activities during camp if required. This transport will be by coach and occasionally by car. During transportation the following principles will be adhered to:

• All drivers will be recruited under the guidelines recommended in the government publication ‘Safe From Harm’ and will have undertaken a Disclosure and Barring Service (DBS) check .
• Transport will be provided in vehicles that are roadworthy, i.e. with a MOT and appropriate insurance.
• Seat belts will be worn at all times by all occupants of the vehicle.

Images of Children
During the week of Camp we would like to take photographs and video recordings of children who attend. These images may appear in our printed publications, they may be shown in church displays and during promotional events

Conditions of Use

• We will not include details of full names (which means first name and surname) of any person in an image on a website, or in printed publications, without good reason and only with your express consent.
• We will not include personal e-mail or postal addresses, or telephone or fax numbers on our website or in printed publications.
• We may use group images with very general labels, such as “youth enjoying sport”

Stating that you consent on the form above confirms that your child is in good health and you consider him/her fit to participate in these activities.