Holiday Youth Programme - WISE UP Workshops CIC

Where did you hear about Wise Up Workshops?*

Name of Attendee:*
Date of Birth:*
What school does your child attend?*
Tel No:*
Email Address:*
Home Address:*

In case of Emergency Contact Details (ICE):
Name:*
Relationship to Attendee:*
Tel Number(s):*

Disabilities (Where Applicable)
Does the attendee have a disability?*
Please let us know which disability:*
Please give us further information on the disability below.*

Any Allergies / Medical Conditions:*
Anything important we need to know?*

Permissions: (Where Applicable)
Do you give permission for the person named (yourself) above to be filmed or photographed during the workshops and featured on Wise Up Workshops website & Social Media.*
- Yes
- No
Do you give permission for the Wise up team to administrate first aid if needed and understand the team will call the ICE number provided to report the incident.*
- Yes
- No
Do you give permission to be contacted by Wise Up Workshops about their events, workshops and general info.*
- Yes
- No

Type of Programme you wish to book today:
No. of People:*
Cost;

Various costs available

The cost includes lunch & refreshments for the full week.

Daily rates available, please call the team.

Once we receive your booking, we will call you for payment details.

Your booking is only confirmed when we receive payment.

By checking this box I agree to all of the above*
- I agree
Date
DD slash MM slash YYYY

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