ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School

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ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
ACTIVITIES DAYS
     BOOKLET 2019

SPROWSTON COMMUNITY ACADEMY
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
Dear Parents, Guardians and Carers,

Activities Days 2019

I am writing to you regarding our Activities Days which will take place from 18th-19th July
2019. All students in years 7, 8, 9 and 10 will be involved, and this booklet gives parents
and students an outline and overview of each activity.

If your child is already going on one of the following trips, you do not need to pick an
activity: Netball World Cup, Berlin or Photography trip to London.

You will need to select your 1st, 2nd and 3rd choice, by completing the slips at the end of the
booklet and return it to Student Reception. If you are unable to print the forms, there will
some available at Student Reception.

You will be able to secure a place for one of the paid for activities by paying the specified
cost of the activity, when the activities go live on Monday 25th February 2019. Please return
money and slips to Student Reception. No monies or reply slips will be accepted before this
date.

Places will be limited for each activity and activities will be allocated on a first come basis.
We therefore recommend that you book early to avoid disappointment as we anticipate
many of the activities filling up very quickly. If your first choice of activity is full and no longer
available, then we will place you in your second or then, third choice.

Should you not opt for an activity by Monday 11th March 2019 then your son/daughter will
be allocated a free, on-site activity.

Students will be informed of the activity they have been successful with by Friday 22nd
March

Please note that for activities that incur a cost, full payment will be required when you return
your reply slip. Please provide payment of the exact amount in cash or cheque (made
payable to Sprowston Community Academy), in an envelope clearly marked with your child’s
name, form, first choice activity and total enclosed. If you are unsuccessful in gaining a place
on your 1st choice activity and your 2nd choice activity is of less cost, your payment will be
returned, uncashed, and you will need to provide us with alternative payment for the new
amount.

For any activity which is free, please complete and return the reply slip at the back of the
booklet and return it to student reception.

Monies paid for trips are non-refundable unless another student can be found to take your
son/ daughter’s place. Please also be aware that any activity which does not attract a viable
amount of students may be subject to cancellation, in which case your payment will be
refunded and you will then need to choose another activity.

Finally, students should be reminded that good behaviour, as outlined in the school
behaviour policy, is expected both before and during all activities. And we reserve the right
to withdraw students who fail to meet the expected standards.

Yours sincerely

M.Kersey
Miss M. Kersey
Activities Days Co-ordinator
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
CONTENTS:

1    Paintball and Climbing

2    Whitlingham Water Sports

3    Surfing Spectacular

4    Multi sports

5    Graffiti Workshop

6    Skiing and Snow Tubing

7    Animal Experience

8    Canoeing + Bushcraft

9    Trampoline + Cinema + Multi sports

10   Trampoline + Cinema + Board game challenge

11   Multi sports + Trampoline + Cinema

12   Chocolate workshop + Trampoline + Cinema

13   The Great Sprowston Bake Off

14   Board Game Challenge + Creating the Perfect Picnic

15   International Games + Krypton Factor

16   Go Karting

17   Golf

18   Musical Theatre PLUS see Matilda the musical at the Theatre Royal

19   Musical Theatre

20   Debate Days

21   Design Model Making

22   Fishing

23   Computer Gaming

24   Make a Wind Chime

25   Harry Potter Extravaganza

26   Go Ape + Cycling in Thetford Forrest

27   Creative Writing

28   Mission to Mars

29   Crafts in The Arc
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
1.Paintball & Climbing

Thursday 9.30am – 2.30pm
Paintballing in Norwich, Plumstead Road. A massive 400 paintballs provided to beat your
opponents! All equipment and clothing provided. Packed lunch required. Own transport to and
from the site required.

Friday 9.30am-12.30pm
Climbing and bouldering at Highball, Twickenham Road Norwich. 3 hours of climbing the walls.
Rope? That is up to you. You decide if you want to rock climb or risk it with bouldering, or why not
try both! All equipment provided. Packed lunch required. Own transport to and from the site
required.

Cost: £45
Maximum numbers: 45              Open to all years
Transport: Students will need to make their own way to and from both venues
For more details speak to Mrs Gilding or Miss Shannon
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
2.Whitlingham Water Sports
There are places for 30 students to participate in a range of water based
activities with Whitlingham Adventure at Whitlingham Country Park in Trowse,
just south of Norwich. Over the two days you will be transported to
Whitlingham by coach from school each morning and take part in the following
watersport activities:
                 Stand Up Paddleboarding                Katakanu

                      Funboat Sailing                 Raft building

Cost:£60
Transport: Return coach from school
Spaces available: 30
Open to all years
Who to speak to for further information: Mrs Wavell
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
3. Surfing Spectacular

                         £
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
4. Multi Sports
Two days of a variety of sports which you as a group can choose

This is a school based activity.

Cost: FREE
Open to all year groups            Spaces available: 40
See Mr Schamp for more details
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
5.Graffiti Workshop

The graffiti workshop will offer an opportunity to create your own graffiti
artwork inspired by well-known artists including Banksy, Shepard Fairey, Reyes
and Saber.

You will be trying out different techniques so that you can create your own
style of graffiti as well as developing your own tag, lettering and graffiti
characters by using colouring pens and pencils. By the end of the activity you
will have produced a large piece of artwork that you can take home.

This activity is open to all ages and ability ranges.

This is a school based activity.

Cost: FREE
Maximum numbers 20
Any specific equipment needed? Pens and pencils but these will be provided
Open to all years
Who to speak to for further information; Mr Price
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
6. Skiing and Snow Tubing

Two days of instructed ski lessons at Norfolk
Snow Sports Club, Trowse.
The first day will involve two sessions of skiing at Trowse and the second day
will consist of one session of skiing and one session of tubing.

This is great opportunity for anyone who wants to improve their ski skills or for
complete beginners who would like to try it out.
Important:
-We will need to know if pupils already have any experience of skiing as the instructors will tailor
their lessons to different abilities.
-Students will need to bring their own packed lunch

Cost: £40
Transport: Return coach travel to the Ski Centre
Any specific equipment needed: Long sleeved top, trousers and gloves
Spaces available: 30                  Open to all Years
Who to speak to for further information: Miss Osbourne
ACTIVITIES DAYS BOOKLET 2019 - SPROWSTON COMMUNITY ACADEMY - Sprowston Community High School
7. Animal Experience

Thursday:
Animal/Wildlife based activity in school

Friday:
Visit to Colchester Zoo 

Cost:   £20                 spaces available: 45

Transport: Friday: Coach leaving school at 8am

Any specific equipment needed: N/A – although packed lunch or money to purchase food/souvenirs at student discretion

This activity is mainly aimed at Year 7 & 8 pupils but others year groups are welcome

Who to speak to for further information: Miss Roche CM17
8. Canoeing and Bushcraft

Do you fancy yourself as a bit of a Bear Grylls? Then
this activity is perfect for you!

Spend two days canoeing down the Norfolk Broads and take
part in bushcraft activities.

Day 1: You will canoe down the river to the woods where you will be
taught the mystical art of bushcraft and make a camp
Day 2: Starts at the woods, where you will finish building your camp,
learn to light fires without matches or lighters and cook your lunch in
the wild. The day will finish with you canoeing up the river

Cost: £60
Maximum numbers: 30        Open to all years
Transport: Minibus to and from Wildlife Activity Centre in Wroxham
For more details see Mr Harvey
9. Trampoline and Cinema Day + Multi sports
Thursday: Trampoline and Cinema
   We will meet you at Riverside and spend some time in the
   morning at Gravity jumping and playing dodgeball. After
   lunch we will chill out and take in a film at the Odeon
   cinema (and maybe grab some popcorn!).

   Students will need to be able to make their own way, with
   written permission from their parents, to and from
   Riverside at the start and the end of the day.

Speak to Miss Dawbarn for more details.

Friday: Multi sports

                                                               The second day will be a fun
                                                               filled, multi sports day in
                                                               school. You will get to choose
                                                               which activities you would like
                                                               to play as a group.

                                                               See Mr Schamp for more
                                                               details.

Cost:£20
Open to all years
Spaces available: 30
Transport: Students will need to make their own way to and from Riverside Entertainment Centre on
Thursday
Students will need to bring their own Gravity socks or buy some on the day
10. Trampoline and Cinema Day + Board Gaming
Thursday: Trampoline and Cinema
   We will meet you at Riverside and spend some time in the
   morning at Gravity jumping and playing dodgeball. After
   lunch we will chill out and take in a film at the Odeon
   cinema (and maybe grab some popcorn!).

   Students will need to be able to make their own way, with
   written permission from their parents, to and from
   Riverside at the start and the end of the day.

Speak to Miss Dawbarn for more details.

Friday: Board Game Challenge

                                                               Spend the day testing your
                                                               sneaky strategies against
                                                               others, playing a range of
                                                               your favourite board
                                                               games. Plus a game unique
                                                               to Sprowston Community
                                                               Academy that has never
                                                               been played before!

                                                               Speak to Miss Baldwin for
                                                               more details

Cost:£20
Open to all years
Spaces available: 30
Transport: Students will need to make their own way to and from Riverside Entertainment Centre on
Thursday
Students will need to bring their own Gravity socks or buy some on the day
11. Multi sports + Trampoline and Cinema Day
Thursday: Multi sports

                                                                  The first day will be a fun
                                                                  filled, multi sports day in
                                                                  school. You will get to choose
                                                                  which activities you would like
                                                                  to play as a group.

                                                                  See Mr Schamp for more
                                                                  details.

Friday: Trampoline and Cinema

 On the second day we will meet you at Riverside and spend
 some time in the morning at Gravity jumping and playing
 dodgeball. After lunch we will chill out and take in a film at
 the Odeon cinema (and maybe grab some popcorn!).

 Students will need to be able to make their own way, with
 written permission from their parents, to and from
 Riverside at the start and the end of the day.

See Miss Dawbarn for more details

Cost:£20
Open to all years
Spaces available: 30
Transport: Students will need to make their own way to and from Riverside Entertainment Centre on
Friday
Students will need to bring their own Gravity socks or buy some on the day
12. Chocolate Workshop + Trampoline + Cinema
Thursday: Chocolate Workshop

Join in and make a series of chocolate desserts and treats.
Cakes, cookies, cheesecake or ice cream they will all have chocolate in common.
Over the course of the day you will make and decorate a variety of delicious items
Practice melting chocolate, combining ingredients and creating sweet treats to take home.

This activity is in school.
Any specific equipment needed: Clean Apron

See Mrs Jenner for more information

Friday: Trampoline + Cinema

                                   We will meet you at Riverside and spend some time in the
                                   morning at Gravity jumping and playing dodgeball. After
                                   lunch we will chill out and take in a film at the Odeon
                                   cinema (and maybe grab some popcorn!).

                                   Students will need to be able to make their own way, with
                                   written permission from their parents, to and from
                                   Riverside at the start and the end of the day.

                                      See Miss Dawbarn for more details

          £20
Total Cost:
Transport: Students will need to make their own way to and from Riverside Entertainment Centre on
Friday
Maximum number: 30                   Open to all years
Students will need to bring their own Gravity socks or buy some on the day
13. The Great Sprowston Bake Off
Thursday: Creating the Perfect Summer Picnic
The perfect summer picnic!!! Lead by Mrs Marsden in JB08

                                                Celebrate the summer with a picnic for 2 to
                                                make and take away (the food not the
                                                basket!). Create 3 to 4 dishes (products still to
                                                be decided) in a cooking session and promises
                                                to be fun (you’ll still have to wash up
                                                though!).

                                                Students will need to bring a variety of
                                                containers to take their products home in.

Friday: Chocolate Workshop

Join in and make a series of chocolate desserts and treats.
Cakes, cookies, cheesecake or ice cream they will all have chocolate in common.
Over the course of the day you will make and decorate a variety of delicious items
Practice melting chocolate, combining ingredients and creating sweet treats to take home.

This activity is in school.
Any specific equipment needed: Clean Apron

See Mrs Jenner for more information

These are both school based activities.

Total Cost: FREE
Maximum number: 20                 Open to all years
14. Board game challenge + Perfect Picnic
Thursday: Board Game Challenge

                                                           Spend the day testing your
                                                           sneaky strategies against
                                                           others, playing a range of
                                                           your favourite board
                                                           games. Plus a game unique
                                                           to Sprowston Community
                                                           Academy that has never
                                                           been played before!

                                                           Speak to Miss Baldwin for
                                                           more details

Friday: Creating the Perfect Summer Picnic

The perfect summer picnic!!! Lead by Mrs Marsden in JB08
   Celebrate the summer with a picnic for 2 to
   make and take away (the food not the
   basket!). Create 3 to 4 dishes (products still to
   be decided) in a cooking session and promises
   to be fun (you’ll still have to wash up
   though!).

   Students will need to bring a variety of
   containers to take their products home in.

These are both school based activities.

Total Cost: FREE
Spaces available: 20
Open to all years
15. International Games + Krypton Factor
Thursday: International games

     Spend the morning playing traditional
     international games.

     Have a late continental breakfast.

     Watch an international film in the
     afternoon.

     Speak to Mrs Hill for more details

                                                                                 afternoon

Friday: Krypton Factor

The Krypton Factor is back in school after 6 years! Ever heard of it? If you are interested in
problem solving, puzzles and treasure hunts then this is for you! Based on the 1980’s and 90’s T.V
series, The Krypton factor is a team game that will test your mental and physical skills to the limit.
There will be a number of challenges you and your team will need to complete to accumulate points
to be in with a chance of winning the all-important Krypton Factor trophy. All you need is
enthusiasm and 100% participation on the day, and you are guaranteed a day like you have never
experienced before!
Who says Activities day spent in school are dull – They obviously have never taken part in the
Krypton factor!

For more information speak to Miss Bales

These are both school based activities.

Total Cost: FREE
Maximum number: 30          Open to all years
16. Go Karting

Two days go-karting at Karttrak, Cromer
Whether you are a beginner or you have experience as a Karter there is
no denying the fun there is in Karting.

Race against the clock, try to improve your lap times, practice your
overtaking, fine-tune your racing line… practice sessions are the perfect
time to enhance your racing skills.

      Sessions are in 15 minute intervals
      Helmets and race suits will be provided. Students must wear sensible shoes,
       (no high heels, open toed shoes, sandals or crocs).

If you are interested see Mr Jones (CM23) for more information

Total Cost: £40
Maximum numbers: 30                 Open to all years
Transport: Coach return to Cromer
17. Golf
Two days of fun filled golf coaching at Eaton Golf Club
The days will give a complete overview of golf: putting game, long game and
golf simulator in the indoor swing studio.

The sessions will be run by a qualified PGA Professional.

Lunch will be provided for you on both days.

Cost: FREE
Spaces available: 16                 Open to all years
Transport: School minibus to and from the golf club
For more details, speak to Mr Panayi
18. Matilda the Musical Workshop and Show

This activity is the same as 19.Matilda themed musical
theatre workshops but with the addition of going to
the Theatre Royal in the evening to see the show!
The activity is suitable for all students. 38 places with show tickets are available at £55

Cost: £55
Transport:Please make you own way to Theatre Royal Norwich for 6.45pm, meeting point TBA
Spaces available: 38           Open to all years
Who to speak to for further information: Mrs Bugdale or Mrs Snell
19. Matilda Themed Musical Theatre Workshops

For all Revolting Children who can sometime be a little bit Naughty!

Join your performing arts teachers to learn songs and
dance routines from the award winning Matilda the
Musical.
The two day workshop will include a chance to learn the songs, script and
choreography for the 20 minute version of Matilda the Musical, including,
School Song, Bruce and Revolting Children.

The activity is suitable for all students.

Total Cost: FREE
Maximum numbers: 30            Open to all years
Who to speak to for further information: Mrs Bugdale or Mrs Snell
20. Debate Days

Are you opinionated?!
Do you love to argue?!
Have you got lots to say?!
Then this could be the activity for you!

Discover Your Voice training will help you turn your discussion abilities into full on debating skills.
This activity is led by a DYV mentor who using games and activities will coach you to be able to put
forward a convincing argument. Through this fun-packed first day, you pick up key debating skills
and learn how to do a formal debate. By the end of the first day, you will put these great new skills
to the test, however day two will be your chance to shine! Using the skills you’ve learnt on the first
day, we will get to two full on debates! (the topics will be decided by you on the day).
It doesn’t matter whether you are outspoken or shy; you will learn the skills to be able to put across
your point of view. You need no previous experience in debating, just an interest and a willingness to
have fun and laugh a lot!

Some Year 9s (now Year 10) took part in a Discover Your Voice day of activities last year. Here are
some comments they made:

“Thank you for a lovely, fun day! I shall definitely remember the advice and use it!”
“That day was fun and educational and I would do it all over again. Thank you for the really good and
educational day.”
“I’m more confident when I speak in front of people and I can make good points about different
topics.”

This is a school based activity.

Cost: Free
Open to all years         spaces available: 30
For further information, please contact Mrs Bouttell in WS06.
21. Design Model Making
           Are you able to think outside the box?
    Could you think up and build working models to solve
                   problems in the world?
   We will look at build and test models that show how designers work in the real world and we
 encourage you think and look at problem solving from all different ways to encourage original and
                                          innovative ideas.

                                                                   Air powered racers

This is a school based activity

Total Cost: FREE
Spaces available: 30                 Open to all years
For more information speak to Mrs Turner
22. Fishing Trip

BIT ABOUT THE FISHERY:

Reepham Fishery is widely regarded as one of Norfolk’s premier pleasure coarse fisheries,
having been established for many years on spring-fed lakes. An extensive programme of
improvements was completed in 2008 which created a popular venue for day ticket fishing,
match fishing , corporate events and holidays. The aim of the fishery is to provide customers
with a quiet undisturbed and safe environment which is as close to nature as possible,
protecting the well-being of the fish, only the fishery landing nets and mats must be used
and we aims to preserve the natural environment as much as possible.

Aim of the Day: To enjoy an outdoor activity that would not normally be undertaken as part
of a school curriculum. This is designed to increase social interaction and involving students
in a fun activity. We aim to create some kind of ‘match’ environment in which there can be
a prizes and awards for most weight caught or biggest fish.

IMPORTANT NOTES:
   1) You will be required to own your own fishing equipment to take part in this trip as
      no equipment or tackle can be provided.
   2) It will be a requirement that you bring along your own bait and only barbless hooks
      are allowed on this venue.
   3) You must have a ROD FISHING LICENCE to legally fish in the UK. The licence is
      currently FREE for anybody under the age of 16 but you still must apply for one via
      the following website: https://www.gov.uk/fishing-licences/buy-a-fishing-licence.

Cost: £20
Maximum numbers 10          Open to all years
Transport: School Mini Bus being provided
Who to speak to for further information: Mr Brierley or Mr Parker
23. Computer Gaming

Try your hand at co-op and player vs player
computer gaming in CM28.

Only 28 spaces available due to room restrictions.

Cost:FREE
School based activity in CM28
Any specific equipment needed. It would help if you had a “steam account”.
Open to all Years
Who to speak to for further information? Mr Kettle
24. Make a Wind Chime
Do you like challenging yourself to make new things?

Spend two days working in Tech to make a wind chime out of
aluminium and wood.

Use your creative skills to design and produce your very own
wind chime.

This is a school based activity.

Total Cost: FREE
Spaces available: 20
Open to all years
Speak to Mr McIntosh for more details
25. Harry Potter Extravaganza

Leave your broomsticks at the door and keep your wands ready for all things wonderfully wizardly
with Harry Potter and of course, the amazing world of the marvellous Magical Beasts……..

- Dress up in your best wizarding world way and get ready to be sorted into Hogwarts houses.
- Design and build an awe-inspiring magical beast of your own.
-Take on the brain-bogging challenges of Harry Potter trivia.
-Ready for the time-bound challenge of the Diagon Alley treasure hunt?
-Take up JK Rowling’s pen and create your new Harry Potter or Fantastic Beasts character.
-Craft and model an awe-inspiring clay dragon.
-Read and enjoy extracts from your favourite Harry Potter books.
-Puzzle through some beastly games and tricky anagrams.
-Need a new wand? Forget Ollivanders and be the master of creating your own from scratch.
-Compete for house points throughout the event. Which Hogwarts house will win?

Muggles, witches and wizards…get ready!!

Cost:FREE
Venue= Sprowston Community Academy Library
Any specific equipment needed: Attend in costume- one element (e.g. hat) or the full works! Also an
interest in all things Harry Potter and Magical Beasts will enhance your enjoyment.
Spaces available: 60                         Open to all years
Who to speak to for further information: Mrs N Whiting, Mrs A Harris and Mr N Jones
26. Go Ape and cycling

This will be a 2 day event. We will travel to Thetford forest by coach and spend one day riding trails
around the forest on hired mountain bikes and the other day doing climbing and games at Go Ape.
The coach will bring you home at the end of each day so there is no overnight stay. If you like being
outdoors, going along and up then this is for you!

Cost:£50
Transport: Coach
Any specific equipment needed. Outdoor clothing, packed lunch, back pack.
Spaces available: 40               Open to all years
Who to speak to for further information. Mr Wavell/Mr Bugdale
27.Creative Writing

Do you like writing poetry, songs/raps, stories or just creating characters? During the workshop we will
be experimenting with different kinds of writing, ways to get inspiration and playing writing games!

We will try out different kinds of writing, such as:

       ‘found’ poetry – creating poems from words we find around us
        automatic writing – writing with your instincts!

We will think about how to overcome writer’s block using images and music to inspire us.

We will be creating unique characters, and thinking about how to write in different genres, which could
be horror, sci-fi, mystery, and many more.

This workshop is for anyone who is interested in telling stories and being creative with words.

Cost: Free

The workshop is in school

Any specific equipment needed: just a pen/notebook

Open to everyone                 Spaces available 20

Who to speak to for further information: Miss Leigh, come and find me/ask for me at student reception
28. Mission to Mars

Do you have an interest in science and investigation?
Ever wondered what it takes to visit Mars?

Spend two days working in the science department
planning a mission to Mars. You will apply your
creativity and science and math knowledge to explore
the Red Planet. Ready, set, let's go!

Some of the things you will do:
   Investigate the best rocket fuel
   Design and build a Mars Rover
   Design and test a landing system

Cost:FREE
This is a school based activity
Any specific equipment needed
Spaces available: 30            Open to all years
Who to speak to for further information: Mrs Tate
29. Crafts in the ARC
                     Do you like to all things crafty?

Get creative with two days of fun arts and craft based
activities in the ARC.

Cost:FREE
This is a school based activity
Maximum spaces available: 15
Open to all years
Who to speak to for further information: Mrs Neilson
PRINT THIS PAGE AND RETURN TO STUDENT
              RECEPTION
Replies will be accepted on/after Monday 25th February 2019.

                                ACTIVITIES DAYS CHOICES

NAME OF STUDENT: ………………………………………… FORM: ………………

Please indicate clearly your son/daughter’s 1st, 2nd and 3rd choices for Activities Days. Write
the number and name of the activity you are opting for. These can be found at the top of the
activity page.

             Activity                                 Activity Name
             Number

   1st

   2nd

   3rd

I enclose the sum of …………………… in cash / cheque, payable to Sprowston Community
Academy (total cost of 1st activity choice)

I understand that this money is non-refundable if my child withdraws from the activity for any
reason, other than medical reasons, with proof of illness.

I do/do not give permission for my child’s photograph to be taken and used in promotional
material by the school or activity venue.

I give my permission for my child to make their own way to and from an activity that states it
is required.

Signature of Parent / Guardian / Carer: ………………………………………………………

Please enclose choices form, medical form and full payment in an envelope
clearly marked with the student’s name, form group, 1st choice activity and total
amount enclosed, identifying if cash or cheque.
Personal information and Parental Consent Form - Category B Visits
                                       CONFIDENTIAL

Please return to : Student Reception asap on/or after Monday 25th February 2019 with
payment (where applicable) and choices form.

The Visit Leader who will only divulge information on this form to other staff as necessary, to ensure
the welfare and safety of the participant.

Activity: ……………………………………………                                                 ( please specify)
Day & date of trip: 18th July 2019 and / or 19th July 2019

To be completed by Parent/Guardian/Carer (PLEASE USE BLOCK CAPITALS)

Young person’s full name: ______________________________Date of birth: ____/____/_____

Home address: _______________________________________________________________

___________________________________________________Post code: ________________

Main telephone no : ____________________________________________________________

Name of parent(s)/guardian(s)/carer{s}: Emergency        Contacts for duration of trip
(i) ______________________________________________Relationship: _________________

(ii) _____________________________________________Relationship: __________________

Addresses of parent(s)/guardian(s)/carer(s) and/or other contact persons:

(i) __________________________________________________________________________

____________________________________________Tel. no. __________________________

(ii) __________________________________________________________________________

___________________________________________ Tel. no. __________________________

Doctor’s name : _______________________________________________________________

Doctor’s Tel. no:_____________________ National Health No.(if known): _________________

Date of last known tetanus injection (if known): __________________________

Please give details of any recent illnesses:
Please give name and dosage of any medications currently being taken:

Please tell us about any allergies, e.g., medicines, food, bee stings, etc.

Please tell us about any food not eaten for religious or health reasons:

Please provide any other information which you feel might be useful in an emergency, or that the
Visit Leader should be aware of: e.g. phobias, epilepsy, hyperventilation, sleepwalking, diabetes,
travel sickness, toileting difficulties, friendship problems, etc.

I am willing for my child to take part in the above visit/journey, and having read all the information
provided, I agree to his/her taking part in the activities described.

I understand that the staff responsible for the activities will take all reasonable care of participants.

I give/do not give* permission for my child/ward to receive pain relieving medication when
appropriate (one dosage of paracetamol only).
* please delete as appropriate

I agree to my child/ward receiving medication as instructed and any emergency dental, medical or
surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the
medical authorities present.

I understand the extent and limitations of the insurance cover provided.

Signature of Parent / Guardian / Carer: ____________________________________________
(if participant is under 18)

Signature of Participant::         __________________________________________________

Should there be any amendments to this form after it has been handed in, please contact the Visit
Leader immediately.

        This form must be completed for each member (including staff) of any group involved in any
        activity that includes absence from home overnight, visits abroad, and/or adventurous
        activities.

        Copies must be carried securely by the Visit Leader or group supervisor.
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