ENROLMENT FORM

NOCN Level 3 Certificate in Forest School Programme Leadership (QCF)

Location:

Tees Valley Wildlife Trust, Margrove Heritage Centre, Boosbeck, Saltburn, TS12 3BZ

Face-to-face days:

Monday 5th and Tuesday 6th October 2015

Monday 19th and Tuesday 20th October 2015

Monday 9th and Tuesday 10th November 2015

Monday 23th and Tuesday 24th November 2015 (Outdoor and Paediatric First Aid)

Monday 1st and Tuesday 2nd February 2016

Monday 18th and Tuesday 19th April 2016

I wish to enrol on the NOCN Level 3 Certificate in Forest School Programme Leadership (QCF) Course / Yes / No
I wish to enrol on the Outdoor and Paediatric First Aid Course / Yes / No
Name of student
(Please write your name as you would like it to appear on your certificate)
Position
Organisation
Address / Postcode:
Telephone
Mobile
Email
Date of Birth
Are you aged 19 or over? / Yes / No
Unique Learner Number
(if previously issued)
Qualifications
(Please give details of relevant qualifications, e.g. teaching, play-work or youth-work qualifications).
Experience
(Please give details of experience working with children or young people).
Do you consider yourself to have a learning difficulty and/or disability? / Yes / No
Details:
The Level 3 training requires completion of a portfolio including the writing of an essay, reports, risk assessments, policies and procedures.
Do you have difficulties with writing? / Please give details of any difficulties you have with writing.
I have read and agree to the terms of booking. / Yes / No

Cost:

£975 NOCN Level 3 Certificate in Forest School Programme Leadership Course and Outdoor and Paediatric First Aid Course

or

£895 NOCN Level 3 Certificate in Forest School Programme Leadership Course

A payment of £350 is due at time of booking. The balance is due on 7th September 2015. If we don’t receive the balance by then we reserve the right to re-book the place.

Booking:

  1. Complete the registration form at or contact or 07814 791671 to check availability.
  1. Complete and send the enrolment form by email to
  1. On receipt of the enrolment form you will be sent an email.
  1. An invoice will be sent.

Please provide details of who to invoice.

Send invoice to: ………………………………………………………………………………………...

  1. On receipt of the deposit payment you will be sent a confirmation email.

North Yorkshire Forest School Training

Tel: 07814 791671 Email:

MEDICAL CONSENT

The information you give here will be treated confidentially, will be held securely and will not be passed to a third party without your permission. It will be held in accordance with the principles of the Data Protection Act 1998.

Name:

Date of Birth:

Gender: Male/Female

Emergency contact name:

Relationship:

Emergency Contact No:

Doctors Name and Contact No:

Please give details of any prescribed medication or advice to be followed in an emergency

Do you suffer from any of the following:

Allergies (including medication, plasters, stings, food, pollen etc.)Yes/No

Asthma or breathing difficulties Yes/No

DiabetesYes/No

Epilepsy, fainting or blackoutsYes/No

Heart conditionYes/No

Sensory loss (sight, speech, hearing)Yes/No

Travel sickness Yes/No

OtherYes/No

Vaccination against Tetanus in the last 10 yearsYes/No

Have you received any medical or surgical treatment in the last 3 months? Yes/No

If you have answered yes to any of the above, please give details

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