Booking Form Test Parent/Guardian DetailsPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First NameLast NameStreet AddressCityZIP / Postal CodeEmail AddressPhoneRelationship to ParticipantParticipant DetailsFirst NameLast NameGenderMale/FemaleMaleFemaleDate of BirthAgeStreet AddressCityZIP / Postal CodeConsentParticipation Consent:Yes/NoYesNoI give my consent to my child participating in the activities listed: Abseiling, Archery, Artificial Cave, Boarding, Bouldering, Bushcraft, Canoeing, Challenge Games, Circus, Skills, Climbing, Crevasse Crossing, Egg Drop, Food Forage, Frisbee Golf, Geocaching, Gorge Crossing, GPS Trail, High Line, Jacobs Ladder, Ladder Climb, Leap of Faith, Log Challenge, Low Ropes, Mountain Biking, Mountaineering Challenge, Night Line, Orienteering, Over the Wall, Pioneering, Pond Dipping, Scavenger Hunt, Search & Rescue, Slack Line, Street Surfing, Vew Do Boards, Walking, Zip Wire. I have been informed of and have read the information relating to the activities. I have ensured that my child understands that it is important that for their own and the groups safety that any instructions given by staff must be complied with.Medical Consent:Yes/NoYesNoI undertake to inform the staff of any changes in the health or medication of my child as and when necessary. I agree that staff from Creative International adventures may, in the event of an emergency, give permission for my child to receive medical treatment.Photography Consent:Yes/NoYesNoI give permission to Creative International Adventures to take photographs of my child for promotional purposes. I understand that the photographs may be used on leaflets, booklets, display material and may also be placed on the Creative International Adventures websites.Venue and Transport Consent:Yes/NoYesNoI am aware that on rare occasions Creative International Adventures use alternative venues and children will be escorted to these areas on foot or public transport by staff or in fully insured staff vehicles.Medical DetailsAllergyAsthmaEpilepsyOtherPre-existing/Known InjuriesDietary / FoodNoneDoes the participant suffer from any of the following medical conditions, injuries or have any special requirements? (Please tick all that apply)Please provide full details of the medical condition / injuries / requirementsWould you like to receive information about Halifax Holiday Club and future activities and events.Yes/NoYesNoPlease select the programme you would like to sign your child up toExplorersExplorers ExtendedExtremeExtreme ExtendedEXPLORER: Please select the days you want your child to attendWednesdayThursdayFridayEXPLORER EXTENDED: Please select the days you want your child to attendMondayTuesdayWednesdayThursdayFridayEXTREME: Select the days you would like your child to attend.MondayWednesdayFridayEXTREME EXTENDED: Select the days you would like your child to attend.MondayWednesdayFridayTOTALPlease select your chosen payment methodPlease select your chosen payment methodIn PersonBACSChildcare VouchersPayPalEdenredSubmit Form