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Book your Child's Holiday Camp Space here

Please complete this form if you wish to book your child onto a science camp. We endeavour to contact you via email within 3 days to confirm that your space has been booked and to request payment. If you do not hear anything please within this time please call us directly on 01865 522775.

Which Venue?

Dates of Camp:

* All Week?

Name of Child 1

Gender

Male Female *

Date of Birth:	*
Age on day:

Name of Child 2

Gender

Male Female

Date of Birth:
Age on day:

Name of Child 3

Gender

Male Female

Date of Birth:
Age on day:

Parent/ Guardian Name:

Relationship to Child(ren):

Home Address:

Post Code:

Emergency contact number 1:

Emergency contact number 2:

Contact Email:

Person Collecting Child(ren):

Relationship to Child(ren):

Please tick if your child has any of the following?

Medical Conditions

Disabilities

Special educational needs

Dietary Requirements

If yes to any of the above, please provide details so we can accomodate your child the best we can

Family Doctor and Practice Name:

Have you used Bright Sparks Science in the past?

Yes No

How did you find out about us?

What School does your child attend?

Do you give consent for any images taken on the day to be used in publicity or publications relating to Bright Sparks?

Bright Sparks may wish to take photographs of the workshop activities for training and promotional purposes.We will not share the images taken or any other information about your child with other outside organisations or use it for any other purpose.

Yes No

By submitting this form, you have given your consent for a member of the Bright Sparks team to administer first aid to your child(ren) in the event of a medical emergency, which in the opinion of a qualified medical practitioner may be necessary.