WheelPower – British Wheelchair Sport

Junior Camp 8th November 2014 Supported by LimbPower and CP Sport

WheelPower – British Wheelchair Sport

Nineteenth Stoke Mandeville Junior Sports Camp supported by LimbPower and CP Sport

Saturday 8th November 2014

WheelPower - British Wheelchair Sport will be hosting the Nineteenth Junior Sports Camp, supported by LimbPower and CP Sport at Stoke Mandeville Stadium, Aylesbury on Saturday 8th November 2014. Entry, Accommodation and Payment forms are attached. Completed forms should be returned by Wednesday 29th October 2014.

The Junior Sports Camp is open to youngsters aged 11 - 18 with a physical impairment. The camp will provide the opportunity to receive coaching in a number of sports. The Sports on offer will include Archery, Wheelchair Basketball, Powerlifting, Rowing, Sitting Volleyball. It is also hoped there will be an opportunity to try out disability cricket and disability target shooting. Limbpower will also be holding a learn to run clinic on the day.

The sessions will take place between 09.30 and 17.00.

Accommodation, if required, will be available on Friday and Saturday night at the Olympic Lodge, Stoke Mandeville Stadium.

The entry fee is: / Saturday only: / £9.00

Lunch will be provided.

If you require any further information please do not hesitate to contact WheelPower – British Wheelchair Sport on 01296 395995 or e-mail . An electronic version of this letter is available.

We look forward to welcoming you to the Camp.

Stewart Jeeves

Sport Development Officer, WheelPower

Ocotber 2014

Please complete entry forms and return by Wednesday 29th October 2014 to:

WheelPower – British Wheelchair Sport

Guttmann Road, Stoke Mandeville, Buckinghamshire HP21 9PP

Tel 01296 395995 Fax 01296 424171

WheelPower – British Wheelchair Sport

Junior Camp 8th November 2014 Supported by LimbPower and CP Sport

Entry Form

To be returned by Wednesday 29th October 2014

Please complete in block capitals and in full

Participant details

Title / Surname / First name(s)
Address
Post Code
Telephone
Date of birth / / / / Age
Email
Brief description of impairment:
Please indicate if you are a manual, power wheelchair user or ambulant:
Powered □ Manual □ Ambulant □

Parent/Guardian/Personal Assistant contact details

All participants must be accompanied by a responsible Parent/Guardian/Personal Assistant.

Title / Surname / First name(s)
Address
Post Code
Telephone / Mobile
Email

WheelPower greatly values your support and would like to keep you informed about future WheelPower events.

Please tick the box if you do not give your permission for this □

Sports

Please tick the Sports in which you would like to take part at the WheelPower – British Wheelchair Sport Junior Sports Camp supported by LimbPower and CP Sport.

Please complete entry forms and return by Wednesday 29th October 2014 to:

WheelPower – British Wheelchair Sport

Guttmann Road, Stoke Mandeville, Buckinghamshire HP21 9PP

Tel 01296 395995 Fax 01296 424171

WheelPower – British Wheelchair Sport

Junior Camp 8th November 2014 Supported by LimbPower and CP Sport

Archery
Basketball
Cricket
Learn to run clinic
Powerlifting
Rowing
Shooting
Sitting Volleyball

Accommodation

To be returned as soon as possible and no later than 29th October 2014

___ We shall not require accommodation for the Junior Sports Camp

___ We shall require accommodation for the Junior Sports Camp

Date of Arrival / Date of Departure
Day / Month / Year / Day / Month / Year
Name(s) for accommodation (please list any additional persons overleaf):
Special Requirements:

Catering

Lunch will be provided free of charge. Breakfast is available at an extra charge (see Payment Form for details)

Dietary Requirements (including parent/guardian/carer if attending):

Medical and Photo Consent Form

PLEASE COMPLETE IN BLOCK CAPITALS

Name / Date of Birth / / /
Address
Post Code
Tel(home) / Tel(mobile)
GP’s Name / Tel
Address

Is there anything we should be aware of to ensure your well-being?

YES NO

If yes please give details:

Are you allergic to penicillin? YES NO

Photography

I understand that WheelPower and its partners may take photographs during the event and permit them to use the images for promotional purposes, including its website.

Please tick the box if you do not give your permission for this □

Please note; it is difficult to ensure an individual is not included by error in group or action shots

Medical Consent

I consent to any emergency medical treatment in the event of an accident

Signed (parent/carer if under 18): ……………………………………………………

Print Name: ………………………………………………………… Date: …………………

Payment Form

Fees must be paid in full with the Entry Form and received by WheelPower by Wednesday 29th October 2014. Registration for the event cannot be confirmed until payment has been received. Refunds can not be issued unless 1 week’s notice of cancellation is received prior to the start of the event unless there are exceptional circumstances.

Please note entry fee is applicable for each individual attending (including parent/guardians). E.g. if parent and participant are attending the entry fee will be £18.00.

Cost / Amount / Total
Accommodation in the Olympic Lodge (prices per person) / Two nights / £25.00
One night / £12.50
Breakfast (per meal) / £3.00
Junior Camp Entry Fee (prices per person) / Saturday / £9.00
Overall Total

*Lunch will be provided on both days free of charge

Payment by Cheque/Postal Order

Cheques, etc should be made payable to: WheelPower

Enclosed within this entry form for the Junior Camp is a cheque for

£

Payment by Credit Card (Visa, Visa Debit, Mastercard)

If you wish to pay by Credit Card please complete the form below in block capitals:

Title / Initials / Surname
Card Number
Valid From / Expiry Date
Issue No. / Security No. (last 3 digits
below magnetic strip)

Please debit my account £ sterling in payment for entry and accommodation/catering for the Junior Camp.

Signature

/ Date / / /

Please complete entry forms and return by Wednesday 29th October 2014 to:

WheelPower – British Wheelchair Sport

Guttmann Road, Stoke Mandeville, Buckinghamshire HP21 9PP

Tel 01296 395995 Fax 01296 424171