Activity Consent Details of Event/Trip/ActivityEvent/Trip/Activity(Required)Please selectY11 Sports Studies Revision SessionsCCF Swynnerton CampY9 Splash LandingsLearner detailsName(Required) First Last Off-site TripsWill the learner have a mobile phone with them during the trip?(Required) Yes No Learner's mobile number(Required) Year group(Required) Year 9 Year 10 Year 11 Year 12 Year 13 Does the learner have any medical / dietary requirements?(Required) No Yes, medical Yes, dietary Please give details for the medical requirement/s(Required)Please give details for the dietary requirement/s(Required)HiddenLiverpool Empire TheatreHiddenConsent and agreement(Required) I confirm that I will make arrangements for my son/daughter to be collected from the academy at 5:00pm and transported home. I understand that payment must be made by 31 January 2023 and failure to do so will result in the place on the trip being withdrawn. I understand that should my son/daughter receive 75 or more negative house points between 31 October 2022 and 8 March 2023 they will forfeit their right to attend. Should this happen, a full refund will be made and their place will be offered to another learner on the waiting list. HiddenNinja Warrior / Ten Pin BowlingHiddenLunch order(Required) Cheese Burger Meal with Fries (drink to be purchased separately for each meal) Veggie Burger Meal with Fries Hot-Dog Meal with Fries Gluten Free Chicken Nuggets with Fries CCF Field day at Swynnerton Training CampI agree to:(Required) Drop off my son/daughter at Denstone College (by the sports hall) on Wednesday, 4 October between 6.15pm-6.45pm. Pick up my son/daughter from Denstone College at 5.30pm on Friday, 6 October. Splash LandingsI confirm that:(Required) The above learner can swim, unaided, for at least 25M Emergency contact detailsPlease provide details in case of an emergency.Name(Required) First Last Contact Telephone Number(Required) Parent/carer detailsThis form needs to be completed by a person with parental responsibility for the above child.Name(Required) First Last I can confirm that:(Required) My child will be collected from The JCB Academy at 17:00 My child will be making their own way home ConsentI acknowledge: The need for responsible behaviour on my son/daughter’s part. In the event of serious misbehaviour before the activity, the Academy may refuse to take my son/daughter on the activity. In the event of serious misbehaviour during the activity, the Academy has the right to exclude my son/daughter from the remaining part of this activity. In either case the Group Leader’s decision will be final and I shall forfeit all monies paid in respect of the activity. I also understand that I may be requested to collect my son/daughter from the visit venue at my own expense in the case of serious misbehaviour. That any photographs or video film taken during the visit must be solely for your individual family’s use and must not be distributed more widely. Photographs may also be taken for publicity use by the Academy. I understand that if the visit is off-site it may involve travelling by coach/car/train and that the above learner needs to wear a seatbelt. I agree:(Required) As the person with parental responsibility I hereby give my consent for my son/daughter to go on the trip/event/activity. I understand that the Principal has the right to deny any learner from attending the trip/event/activity. Data ProtectionWe take spam very seriously and any personal information we collect from this website will be used in accordance with the Data Protection Act 2018 and other applicable laws. You can change your mind at any time by clicking the unsubscribe link in the footer of any marketing emails that you may receive from us in the future. For more information about our privacy practices please visit our privacy policy page on our website. CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
