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Child information

Date of Birth
Day
Month
Year

Parent/Guardian Details

Primary contact

Seconary contact

Medical Information

Does your child have any medical conditions?
Does your child have any allergies (e.g. plants, pollen, bee stings)?
Is your child currently taking medication?

Outdoor and Activity Awareness

I understand that gardening activities may involve use of tools, soil, insects, and outdoor conditions.
Yes
No
I give permission for my child to take part in all gardening activities.
Yes
No
I consent to basic first aid being administered if necessary
Yes
No

Photo and Media Consent

I have an instagram account where I promote my business

I give permission for my child to be photographed/videoed and used on my social media:
Yes
No

Collection Arrangements

My child is allowed to walk home alone:
Yes
No

Additional Information

Does your child have any additional needs or support requirements?
Yes
No

Consent and Agreement

I confirm that the information provided is accurate and up to date. I give permission for my child to attend the Gardening After-School Club and agree to follow the club’s rules and policies.
Yes
No
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Date
Day
Month
Year
6 weeks - Starting from 15/09/26
£108
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