Consent Form

Parent Full Name

Childs Full Name

Parents Email

Parent Mobile No.

What camp or course is your child attending?

Secondary Emergency Contact

In case of emergency contact name

In case of emergency contact mobile no.

In case of emergency contact relationship

Health & Safety

Does your child suffer from any allergies? *

No

Yes

Does your child have any illness or injury that we need to be aware of? *

No

Yes

Is you child on any medication? *

No

Yes

Does you child have any special needs that we need to be aware of? *

No

Yes

If you answered yes to any question, please elaborate

*If your child requires a SNA in school their SNA will need to attend the course/camp with them and we need to be made aware so we can plan accordingly.

Final Bits

How did your hear about us?

Please confirm that you are aware that you child will be using a sewing machine, hand needles, and scissors during this service and that therefore you understand the risks.

As a small business we are trying to spread the word that we are here, please confirm if you are happy for your child to be in pictures.

Initials

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

EXPLORE

SUPPORT

SOCIAL

Creative Assemble Ltd

Company Registration 738853

22 Northumberland Rd, Ballsbridge, D04 ED73

bottom of page