BRAES OF DERWENT [SOUTH] BRANCH OF THE PONY CLUB
SUMMER MAIN CAMP 2014
CONSENT FORM
PLEASE RETURN THIS FORM TO Diane Trewick (at address below) ASAP & at latest by 30th June – you will not be able to attend camp without this returned form
NAME………………………………..
I/We hereby consent to my/our son/daughter attending Summer Camp on …………………to …………………………. At Stonechester, North Lane, Crook, Co Durham; and that my/our son/daughter will consent to the rules laid down by the Committee which are made to safeguard the well being of my/our son/daughter.
I/We understand that the owners of Stonechester will accept no liability for any items lost, broken or stolen during my/our son/daughter’s time at summer camp.
In the event of emergency, I/We further consent to any medical treatment being administered by qualified practitioners to my/our son/daughter during his/her time at Summer Camp and also to the administration of any veterinary care administered to their horse/pony in the case of emergency.
Signed……………………………………………………….Parent/Guardian
Date…………………………..
In the event of Emergency my contact number is:
Daytime……………………………………..Evening…………………..
Please use the space below to list any medical conditions and/or issues which may affect your son/daughter’s enjoyment of camp. Please include any dietary requirements he/she may have. You may want to add any information which you feel would be useful for camp supervisors to know about your child.
Free Camp 2014 Polo Shirt (please tick required size)
9-11 12-13 Adult Small Adult medium Adult Large
SLEEPING ARRANGEMENTS:
Where possible we are planning to allocate tents in age groups but it would also be helpful if you could tell us about any friendship groups you would like to be with – please note this will not guarantee you will all be together!
I would like to share with ………………………………………………………….
Monday drop off arrangements
I need to drop off my child early to go to work YES NO
If yes – 6.30am 7.00am 7.30am
PARENT / ADULT HELPERS
Please note ALL children must nominate at least one parent / adult to assist with Camp who can help during one of the slots below.
Please identify in the table below where you are able to help during the week (you can tick as many as you are able to support):
Day / Breakfast (8-10am / Lunch (11.30-1.30) / Dinner (5-8pm) / Sleep (6pm-10am)Monday
Tuesday
Wednesday
Thursday
Friday
Saturday clean up ( 9-12am)
I am able to transport children to evening activities:
Wednesday: Swimming 6-9pm Yes / No how many?
Thursday: Barn Party (Stapleton Manor) (time TBC) Yes / No how many?
NAME of Parent Helper:………………………………………………………………
Contact tel number:
Please return to – Diane Trewick –The Hemmel, Stobbilee Farm, Lanchester, Durham DH7 0SZ