MIND IN MOTION SUMMER PROGRAMME

Registration & Consent Form

Thank you for your interest in Mind in Motion.

Mind in Motion is a unique summer programme delivered by Compass Learning in partnership with CrossFit, combining movement, wellbeing and fun activities to help children build confidence, resilience and positive relationships.

Movement for the body. Strategies for the mind. Confidence for life.

Please complete the form below. A place is not confirmed until registration has been reviewed and payment has been received.

PAYMENT INFORMATION

Mind in Motion Summer Camp - £35 Per day

£99 per child (3-day programme)

Ready for What’s Next Transition Sessions

£25 per session or £65 for all 3 sessions

Once your registration has been reviewed, payment details will be sent by email. A place is only confirmed once payment has been received.

SECTION 1: PERSONAL DETAILS

Full name of child & any preferred name

Date of Birth

Month

Day

Year

Current Year Group & School Name

School Name

Which programme are you booking for?

Week 1 Mind in Motion Summer Camp 27th-29th July

Week 2 Mind in Motion Summer Camp 3rd-5th August

Ready for What’s Next - Sunday Session 1 9th August

Ready for What’s Next - Sunday Session 2 23rd August

Ready for What’s Next - Sunday Session 3 30th August

SECTION 2: PARENT/CARER DETAILS

Parent/Carer Full Name

Relationship to Child

Phone

Address

SECTION 3: EMERGENCY CONTACTS

Please provide two emergency contact Names, Relationship to Child & Telephone Number

SECTION 4: MEDICAL & ADDITIONAL INFORMATION

Does your child have any medical conditions we should be aware of?

Yes

If yes, please provide details.

Does your child take any medication?

Yes

If yes, please provide details.

Does your child have any allergies or dietary requirements?

Yes

If yes, please provide details.

SECTION 5: HELPING YOUR CHILD SUCCEED

To help us provide the best possible experience, please tell us anything that would help us support your child.

This may include: • SEND needs • Sensory preferences • Communication needs • Anxiety or wellbeing considerations • Strategies that help your child feel safe and successful

What are your child’s strengths, interests or passions?

SECTION 6: COLLECTION ARRANGEMENTS

Who is authorised to collect your child?

SECTION 7: PHOTO CONSENT

Photographs and videos may be taken during sessions for promotional purposes.

I give permission for photographs/videos of my child to be used by Compass Learning and CrossFit.

I do not give permission.

SECTION 8: CONSENT & DECLARATION

Please tick to confirm

I give permission for my child to participate in Mind in Motion activities, including age-appropriate CrossFit and movement-based activities.

I confirm that the information provided on this form is accurate and complete to the best of my knowledge.

I agree to inform Compass Learning of any changes to my child’s medical or emergency contact information.

I understand that all reasonable steps will be taken to ensure the safety and wellbeing of participants.

I understand that participation may be adapted if staff believe an activity may pose a risk to my child or others.

I understand that Compass Learning and CrossFit have safeguarding, health and safety and first aid procedures in place.

I consent to Compass Learning storing and processing the information provided for the purposes of delivering this programme.

FINAL DECLARATION

Parent/Carer Full Name By typing my name below, I confirm that I am the parent/carer of the child named on this form and consent to their participation in the programme. Thank you for registering for Mind in Motion.

Consent & Privacy Note

I consent to my data being used in line with Compass Learning’s privacy policy

MIND IN MOTION SUMMER PROGRAMME

Registration & Consent Form

Thank you for your interest in Mind in Motion.

Movement for the body. Strategies for the mind. Confidence for life.

Please complete the form below. A place is not confirmed until registration has been reviewed and payment has been received.

PAYMENT INFORMATION

Mind in Motion Summer Camp - £35 Per day

£99 per child (3-day programme)

Ready for What’s Next Transition Sessions

£25 per session or £65 for all 3 sessions

Once your registration has been reviewed, payment details will be sent by email. A place is only confirmed once payment has been received.

SECTION 1: PERSONAL DETAILS

Full name of child & any preferred name

Date of Birth

Month

Day

Year

Current Year Group & School Name

Which programme are you booking for?

Week 1 Mind in Motion Summer Camp 27th-29th July

Week 2 Mind in Motion Summer Camp 3rd-5th August

Ready for What’s Next - Sunday Session 1 9th August

Ready for What’s Next - Sunday Session 2 23rd August

Ready for What’s Next - Sunday Session 3 30th August

SECTION 2: PARENT/CARER DETAILS

Parent/Carer Full Name

Relationship to Child

SECTION 3: EMERGENCY CONTACTS

Please provide two emergency contact Names, Relationship to Child & Telephone Number

SECTION 4: MEDICAL & ADDITIONAL INFORMATION

Does your child have any medical conditions we should be aware of?

Yes

If yes, please provide details.

Does your child take any medication?

Yes

If yes, please provide details.

Does your child have any allergies or dietary requirements?

Yes

If yes, please provide details.

SECTION 5: HELPING YOUR CHILD SUCCEED

To help us provide the best possible experience, please tell us anything that would help us support your child.

This may include: • SEND needs • Sensory preferences • Communication needs • Anxiety or wellbeing considerations • Strategies that help your child feel safe and successful

What are your child’s strengths, interests or passions?

SECTION 6: COLLECTION ARRANGEMENTS

Who is authorised to collect your child?

SECTION 7: PHOTO CONSENT

Photographs and videos may be taken during sessions for promotional purposes.

I give permission for photographs/videos of my child to be used by Compass Learning and CrossFit.

I do not give permission.

SECTION 8: CONSENT & DECLARATION

Please tick to confirm

I give permission for my child to participate in Mind in Motion activities, including age-appropriate CrossFit and movement-based activities.

I confirm that the information provided on this form is accurate and complete to the best of my knowledge.

I agree to inform Compass Learning of any changes to my child’s medical or emergency contact information.

I understand that all reasonable steps will be taken to ensure the safety and wellbeing of participants.

I understand that participation may be adapted if staff believe an activity may pose a risk to my child or others.

I understand that Compass Learning and CrossFit have safeguarding, health and safety and first aid procedures in place.

I consent to Compass Learning storing and processing the information provided for the purposes of delivering this programme.

FINAL DECLARATION

Consent & Privacy Note

I consent to my data being used in line with Compass Learning’s privacy policy