Your email: *

    Child’s full name: *
    Age: *
    Class at school (if they attend):
    Parent/ Carers full name: *
    Home address: *
    Parent's contact phone number: *
    Emergency contact name and phone number *

    Diabetes: *
    Heart condition, fits, fainting or blackouts: *
    Severe headaches or migraine: *
    Epilepsy: *
    Anxiety or depression: *
    Diabetes: *
    Any other allergies or reactions (nut allergy, plaster allergy, bee stings): *
    ADHD: *
    Receiving any medical treatment: *
    Has your child been given a Tetanus vaccination in the last ten years: *
    Other illness or disability not named above: *
    Is your child disabled? *
    If ‘YES’, do they have any specific needs that need addressing in order for them to participate fully in Forest School?
    If you answer ‘YES’ to any of the above, please give full details below including any prescription medication that has or is being taken:
    Does your child have any dietary requirements? Please specify:
    Name and address of family doctor: *
    Doctor’s telephone number: *

    Medical consent: I give my permission for Urban Outdoors to manage any medication that my child takes regularly (asthma medication etc.). I give my consent for Urban Outdoors to apply sun cream to my child if necessary. If my child becomes ill or has an accident that requires emergency treatment, and the parent/guardian or emergency contact cannot be reached, I authorise all medical and surgical treatment, X-ray, laboratory, anaesthesia and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency. *
    Activities and safety consent: I give permission for my child to participate in the Forest School sessions organised by Urban Outdoors including all the activities involved. I understand that although the Forest School leaders supervising the activities will take all reasonable care of participants, they cannot necessarily be held responsible for any loss, damage or injury my child suffers as a result of the sessions. Urban Outdoors aims to provide a safe, secure environment for all young people participating in its sessions. Risk assessments will be undertaken for all activities and all young people will be supervised during sessions. All staff are trained and hold DBS certificates Young people participating in the sessions are considered to be responsible for their own actions. By signing this form you accept that your child will abide by the rules of the sessions. *
    Photo Consent Form: We regularly takes photos and videos of visitors and activities for observation work and publicity purposes. Before taking images of children under the age of 16, we need parent/guardian permission. May we use images of your child for publicity purposes in brochures, press releases, on social media or on our website? *