PICK UP AND DROP OFF TIMES:
My child is a pupil at SMHMy child is not a pupil at SMH
I agree to my child taking part in the SMH Holiday Club and their participation in the activities described in the programme and I acknowledge the need for them to behave responsibly.
Please detail any conditions requiring medical treatment or medication and give specific details of symptoms, medication and dosage:
Please detail any dietary requirements:
Please detail any forms of allergy or allergic reaction (e.g. medication, nuts, stings) and details of any symptoms, medication and dosage:
To the best of your knowledge, has your child been in contact with any contagious or infectious diseases or suffered from anything in the last four weeks that may be contagious or infectious? (If YES please give specific details
When did your child last have a tetanus injection?
Emergency Contact 1
Emergency Contact 2
PLEASE INFORM THE GROUP LEADER AS SOON AS POSSIBLE OF ANY CHANGE IN THE MEDICAL OR OTHER CIRCUMSTANCES BETWEEN NOW AND THE START OF THE HOLIDAY CLUB.
I understand that the Stonyhurst school nursing service does not operate over the holiday period and I agree to my son / daughter receiving first aid and emergency medical treatment from SMH Holiday Club staff.