Registration

Registration
Camper/Student Name

First Name Last Name Class (ie P3)
Parent Name

First Name Last Name
Address

Street Address

Street Address Line 2

City County

Post Code
Phone Number
number which you can be contacted during the day
Email
example@example.com
Summer Camp Programmes

Ecologic Backyard Science/Spy School Combo Artventure
Registration (Half-term/Summer Camp)

Full Day Week (£120.00) 1/2 Day Mornings (£60.00) 1/2 Day Afternoons (£60.00)
After Schools Programmes

Ecologic (£30.00) Playground Science (£30.00) Animation (£30.00) Smarts of Art (£30.00) Discovery Club (£30.00) Spy School (£30.00)
Please indicate which school you attend
Please list any allergies healthcare concerns, medical needs or learning/behavioural issues below:
Emergency Contact Details

Name Phone Number
Emergency Contact Details

Name Phone Number
Release Form:

The emergency contacts listed are authorised to make emergency decisions on my behalf if I cannot be reached. My child has permission to participate fully in discovery company programmes. Sun cream or plasters may be administered to my child if believed necessary. My child may photographed for possible discovery company publications. I have read and agree to the terms and conditions. (Below)
Signature

Clear
Should be Empty:

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