Name of Child
First Name
Last Name
Name of Parent/Carer
First Name
Last Name
Emergency Contact Number
Transport Your child will be transported to and from activities and/or from home/school, these times and destinations may differ from day to day depending on activity. The usual mode of transport will be Private Hire Taxi and World Minibus, however other modes of transport may include; walking, public Transport (Bus, Metro, Ferry and Train) hired minibus and staff member’s private cars.
Homely Remedies You give permission for your child to receive paracetamol, antihistamines and plasters.
Activities Your child will take part in a variety of activities during his WORLD placement, these include (but are not limited to):
I, being the parent/guardian of the person named, declare that he/she
is not subject to restriction by virtue of Section 21 of the Firearms Act 1968 (which applies to persons
who have served a term of imprisonment or youth custody) and give permission for the named
individual to take part in Target Shooting .177 Air Rifles and/or Cross Bow and/or Pistol Shooting.
Photos / Videos Your child may be photographed and/or video recorded during his WORLD placement; these photos may be used for a variety of different reasons including: Website, Facebook, Advertising Materials including flyers/posters/business cards/banner and Reporting to Schools.
Dietary Requirements
My child has the following dietary requirements that staff need to be aware of:
First Aid / Medical Conditions Because of the nature of the various practical activities we participate in on a daily basis, unfortunately your child may experience a medical emergency. In the event of this happening the staff will:
My child has the following medical condition/s that staff need to be aware of:
Alcohol / Drugs / Weapons / Mobile Phones The following items are banned from WORLD and will be immediately confiscated, schools and/or authorities will be informed and this will result in a fixed term exclusion:WORLD ACCEPTS NO RESPONSIBILITY FOR LOSS OR DAMAGE!!!
Abusive Language / Bullying / Damage of Property The following will not be tolerated at WORLD, schools and/or authorities will be informed and this will result in a fixed term exclusion:
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