Easter Holiday Cricket Coaching
Monday 20th and Tuesday 21st April 2020
I would like my son / daughter to attend the Cricket Coaching Workshop(s) at Wellesley House on the following day(s):
Monday 20th April £ Tuesday 21st April £
I enclose a cheque for £ ……………………….……………………….. payable to Wellesley House School.
Child’s name: ………………………………………………………………………………………………………………….…….…..…
Home address: ……………………………………………………………………………………………………………….……………
……………………………………………………………………………………………. Postcode: …………………………..……...
Age: ………………………………….. School: …………………………………………………………………….…………………..
I am interested in a minibus pick-up / drop-off minibus service: Yes / No
Does your son / daughter have any medical conditions / allergies? Yes / No
If yes, please give further details: ……………………………………………………………………………………..………….
…………………………………………………………………………………………………………………………………………..………….
Parent Name: ………………………………………………………………………………………………………………..…………….
Home address: ………………………………………………………………………………..…………………………………………..
………………………………………………………………………………………………. Postcode: ………………………………….
Email: …………………………………………………………………………………………………………………………………………..
Emergency contact 1: ………………………………………………………………………………………………………………….
Emergency contact 2: ………………………………………………………………………………………………………………….
If you are unable to contact me and my child requires urgent medical attention while at the Cricket Coaching Workshop, I authorise you to make the decision on my behalf should consent be required for urgent treatment (including general anaesthetic, blood transfusion or operation) recommended by a doctor, or to receive first aid.
Signed: ………………………………………………………………………………………………………… (Parent / Guardian)
Print name: ………………………………………………………………………………………………………………………………..
Relationship: ……………………………………………………………………………… Date: ………………………………….
Once completed, please return the form, plus payment, to: Mrs Baird, Headmaster’s PA, Wellesley House, Broadstairs, Kent, CT10 2DG. Thank you.
09 March 2020
© Thanet Wanderers Rugby Union Football Club 1891-2024 - All Rights Reserved
