Out and Active
Thank you for enquiring about ‘Out & Active’ at Rosliston Forestry Centre. To book your child’s place please complete this form and return it to us as soon as possible along with the correct payment.
Below are a few important details regarding the day, but should you need any further information, please call 01283 563483.
Payment can be made by cash (in person at the Centre) or cheque (made payable to ‘South Derbyshire District Council’) and is non-refundable (this still applies if the child cannot attend due to sickness). I am sorry but no card payments are accepted on this activity. Only full payment secures a place on the activity days. The cost is £20 per child per day.
The day will run from 9am until 5pm. Please be prompt with regards to these times as there is no adult supervision prior to or after the day’s activities, therefore we cannot take responsibility for your child outside of these times.
Please ensure that your child/children wear suitable clothing. A waterproof jacket is essential, as the activities will go ahead even if it rains (unless it becomes a health and safety issue.)
You child/children will need a packed lunch and drinks. It will not be possible for them to buy food from the restaurant.
Please also ensure that any required medication is brought with them (ie. inhalers etc), and that our staff are informed of this medication.
Timetabled activities are subject to change dependant on weather conditions.
Children must be 8years or over.
You will be required to sign your child in and out each day. Please inform staff if someone other than yourself is coming to collect your child/children.
Out and Active
Please complete this Registration form in full and return to Rosliston Forestry Centre in order to book your place(s).
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Child’s full name: ...... Date of birth: ......
Address: ......
......
Emergency Contact: ...... Relationship to child: ......
Telephone number: ...... Mobile: ......
Email address: ...... Please complete if you would like to receive information about future events.
Please detail here any medical conditions/allergies or any other information that you think our staff should be aware of: ......
......
Please read this section carefully and sign at the bottom:
I agree to my child taking part in the activities as described. I consent to any emergency treatment as necessary during these activities. I therefore authorise the activity leader to sign, on my behalf, any written form of consent required by the hospital/dental authorities, should a surgical operation or serum injection be deemed necessary and provided that any delay required to obtain my signature, might be considered, in the opinion of the doctor/dentist concerned, likely to endanger my child’s health or safety.
Has your child been actively sensitive to penicillin?
Yes/No/Don’t know (please delete)
Do you consent to your child being photographed/filmed and those images being used for publicity purposes?
Yes/No
Signed: ...... Date: ......
Out and Active
I would like to book my child onto Out and Active on the following days:
Day / Mon / Tue / Wed / Thurs / FriDate
Please tick the appropriate day(s) and detail the date. Thank you.
Please return this half of your booking form and payment to: Rosliston Forestry Centre, Burton Road, Rosliston, Swadlincote, Derbyshire, DE12 8JX.
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OFFICE USE ONLY:
Name on chequeReceipt Number
Amount Paid
OUT AND ACTIVE
HOLIDAY CLUB
At Rosliston Forestry Centre