Activity Days Booking Form

This form must be completed & arrive at the centre before your child’s first session.

You can return this form in person - by printing it off – or by emailing it back to

Child’s name: / Age:
Address: / School year:
Postcode:
Email address:
DOB: / Phone no.:
Swimming ability: / Stage: / Armbands:

Dates Required

Easter

Week 1 / Full Week
7/4 – 10/4 / Monday
-closed- / Tuesday
7/4 / Wednesday
8/4 / Thursday
9/4 / Friday
10/4
Week 2 / Full Week
13/4 – 17/4 / Monday
13/4 / Tuesday
14/4 / Wednesday
15/4 / Thursday
16/4 / Friday
17/4

Summer

Week 1 / Full Week
27/7 – 31/7 / Monday
27/7 / Tuesday
28/7 / Wednesday
29/7 / Thursday
30/7 / Friday
31/7
Week 2 / Full Week
3/8 – 7/8 / Monday
3/8 / Tuesday
4/8 / Wednesday
5/8 / Thursday
6/8 / Friday
7/8
Week 3 / Full Week
10/8 – 14/8 / Monday
10/8 / Tuesday
11/8 / Wednesday
12/8 / Thursday
13/8 / Friday
14/8
Week 4 / Full Week
17/8 – 21/8 / Monday
17/8 / Tuesday
18/8 / Wednesday
19/8 / Thursday
20/8 / Friday
21/8
Week 5 / Full Week
24/8 – 28/8 / Monday
24/8 / Tuesday
25/8 / Wednesday
26/8 / Thursday
27/8 / Friday
28/8

Please note that full payment is required at the time of booking

Additional Information (anything the staff may need to know. This may include – but is not limited to – medical information, special needs, behavioural needs, etc.)

Emergency Contacts & Relationships To Child

1 / Name: / Phone no.:
Relationship:
2 / Name: / Phone no.:
Relationship:
3 / Name: / Phone no.:
Relationship:

I agree that if my child requires urgent medical attention whilst under supervision of the leisure centre, and it is not possible to contact the emergency contacts, a member of Poynton Leisure Centre staff is authorised to seek medical advice or treatment for my child.

Signed: / Date:

Parent Feedback

We endeavour to provide the best possible experience for all children at all times. Please tell other parents if you are happy with your experience: if you have any concerns or suggestions please tell us. We value your feedback and use it to develop and improve our services. Concerns can be raised with the Activity Days leader, or with the Leisure Centre Manager.

Photography

We occasionally take photographs as a record of activities or for promotional purposes (including – but not limited to - leaflets, the website and facebook). If you DO NOT wish your child to be photographed please tick the box.