Halloween Camp

We are currently taking bookings for the Brill Dunhill Halloween Camp.
To book your child’s place on the Brill Dunhill Halloween Camp please complete the form below:

Name of parent/guardian *

First

Last

Email *

Primary Contact Number *

Secondary Contact Number *

Number of children attending? *

Halloween Camp – How many days have you booked *Two daysThree daysFour days

Please note that you must book a minimum of two days

Halloween Camp – How many days have you booked *Two daysThree daysFour days

Please note you must book a minimum of two days

Halloween Camp – How many days have you booked *Two daysThree daysFour days

Please note that you must book a minimum of two days

Please let us know the days you want your child(ren) to attend

• Tuesday
• Wednesday
• Thursday
• Friday

Name of child 1 *

First

Last

Age of Child 1 *

Name of child 2

First

Last

Age of Child 2

Name of child 3

First

Last

Age of Child 3

Will you be making use of the Early Drop-Off and/or Late Pick-Up Scheme? *

• Yes
• No

€5 early drop off, €5 late pick up, per child, per day. Payment is due at the start of camp.

Does your child have any allergy/medical conditions that we need to be made aware of? If so please give details below. *

Please give the name of your child and as much detail as needed

Does your child have a disability or any other additional needs that we need to be made aware of. Please give details below. *

Please give the name of your child and as much detail as needed

My child(ren) has/have volunteered to participate in The Dunhill Sports Centre Halloween Camp and we understand that this involves physical activity. To my knowledge my child(ren) does not have any physical condition other than those outlined above which preludes participation in this camp. I waive any responsibility of personal damage which may be blamed on such a programme now or in the future and accept responsibility for requesting my child(ren) to participate in this camp. *

• By ticking this box you AGREE to the above statement.
• By ticking this box you DO NOT AGREE to the above statement and your child will be unable to attend camp

I understand the personal data on this form will be used by Dunhill Sports Centre for the contractual purpose of registering/ re-registering and maintaining my Child's camp application. I understand that the personal data will be retained by Dunhill Sports Centre for such period as the camp takes place. I understand that I can resign my child's camp application by writing to Dunhill Sports Centre and my personal data will be erased. I understand that if I do not provide my personal data my child cannot partake in camp. *

• By ticking this box you AGREE to the above statement.
• By ticking this box you DO NOT AGREE to the above statement and your child will be unable to attend camp

I consent to my child receiving first aid treatment by a qualified staff member if they require it. *

• Yes
• No

Do you give consent to Dunhill Sports Centre to retain your details to keep you informed about other news/activities related to the Centre? *

• Yes
• No

I consent to the use of my child's photographs or video footage on Dunhill Sports Centre's website, newsletter, social media and in publications as well as newspapers. I understand that I can withdraw my consent at any time by contacting Dunhill Sports Centre. *

• Yes
• No

By signing below, I am in agreement that I have read and understand the above form and that I have filled it out correctly and honestly to the best of my knowledge. Sign and Date below please. *

Date

Time

Signature

Clear Signature

Total

0,00 €

Square *

Card

Name on Card

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