Where did you hear about our summer camps? * Recommendation (family/ friends) Advertisement (online/ offline) Own research (online) Education Agent Other
Name of the agent
Asthma * Please select Yes No
Asthma Details
Fits or fainting * Please select Yes No
Fits or Fainting Details
Severe/recurring headaches * Please select Yes No
Severe/recurring headaches Details
Diabetes * Please select Yes No
Diabetes Details
Allergies to medicines or other (incl. hay fever) * Please select Yes No
Allergies to medicines or other (incl. hay fever) Details
Does your child receive psychological support or have any psychological conditions * Please select Yes No
psychological conditions Details
Has your child had any recent fractures, operations or injuries which may affect their participation * Please select Yes No
Recent fractures, operations or injuries Details
Any dietary requirements * Please select Yes No
Any dietary requirements Details
Is your child immunised against Tetanus, Diptheria, Polio and Pertussis; please ensure boosters are given when required. * Please select Yes No
Is your child immunised against TBE? * Please select Yes No
I consent to my child receiving homely remedies * Please select Yes No
I consent to my child receiving homely remedies Details
I authorise StGIS to give consent for emergency care for my child during their duration as a student at the camp. * Please select Yes No
consent for emergency care Details