Play Streets STOCKBRIDGE ACTION YOUTH / GREEN GUARDIANS

Summer Stockbridge Action Youth Booking Form

Please complete this form to sign up Stockbridge Action Youth (SAY) Sessions who will be focussing on developing their upcycling & Green Fingers over the summer holidays. SAY is a weekly social action project delivered by VIBE for Stockbridge Young People aged 10+yrs. Over the summer, the group are on the look out for new members to join them, with the focus on doing up an unloved space e.g. a disused alleyway. This will be transformed by upcycling items, painting and doing a general bit of TLC that will hopefully result in a beautiful space that brings neighbours together.

Session Details

When: Thurs 5.45 - 7.45pm (every Thursday)

Where: Meet at Craigs Community Centre, Little Moss Hey (by the highrises)

Age: aimed at 11+yrs but interested 10yr olds welcome too!

Food will be provided for participants at the sessions over summer.

If you are unable to make a session or have any questions please contact VIBE youth workers:

Laura: 07920227607 Laura.Nolan@vibeuk.org

Helen: 07867503745 helen.mcgorrin@vibeuk.org

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* 1. Childs Details Please complete for each child

Child 1 First Name

Child 1 Second Name

Child 1 Age

Child 2 First Name

Child 2 Second Name

Child 2 Age

Child 3 First Name

Child 3 Second Name

Child 3 Age

Child 4 First Name

Child 4 Second Name

Child 4 Age

Child 5 First Name

Child 5 Second Name

Child 5 Age

Child 6 First Name

Child 6 Second Name

Child 6 Age

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* 2. Address Details

Address

Address 2

City/Town

Post Code

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* 3. Parent/Carer Contact Details

Parent/Carer First Name

Parent/Carer Second Name

Relationship to child

Contact Number

Email Address

Address (if different to child)

Postcode (if different to child)

Will you attend with your child/ren?

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* 4. Please answer the following questions for each child which includes permissions:

	You can give my child food / packed lunch	My child is entitled to a free school meal	You can put plasters on my child
Child 1	Child 1 You can give my child food / packed lunch menu	Child 1 My child is entitled to a free school meal menu	Child 1 You can put plasters on my child menu
Child 2	Child 2 You can give my child food / packed lunch menu	Child 2 My child is entitled to a free school meal menu	Child 2 You can put plasters on my child menu
Child 3	Child 3 You can give my child food / packed lunch menu	Child 3 My child is entitled to a free school meal menu	Child 3 You can put plasters on my child menu
Child 4	Child 4 You can give my child food / packed lunch menu	Child 4 My child is entitled to a free school meal menu	Child 4 You can put plasters on my child menu
Child 5	Child 5 You can give my child food / packed lunch menu	Child 5 My child is entitled to a free school meal menu	Child 5 You can put plasters on my child menu
Child 6	Child 6 You can give my child food / packed lunch menu	Child 6 My child is entitled to a free school meal menu	Child 6 You can put plasters on my child menu

Other (please specify)

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* 5. Please provide details of any allergies or medical conditions we need to be aware of before giving them a packed lunch? If you leave this blank we will assume that there are no allergies.

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Anything else?

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* 6. I give permission for my child’s photo to be taken as part of Play Streets and be used by ForHousing & Play Street partners on Social Media, press articles, internal articles etc..

	I consent to my child's photo being taken
Child 1	Child 1 I consent to my child's photo being taken menu
Child 2	Child 2 I consent to my child's photo being taken menu
Child 3	Child 3 I consent to my child's photo being taken menu
Child 4	Child 4 I consent to my child's photo being taken menu
Child 5	Child 5 I consent to my child's photo being taken menu
Child 6	Child 6 I consent to my child's photo being taken menu

Other (please specify)

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* 7. Please use this space to make us aware of any access of any additional needs your child or children may have.

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* 8. I would like to book Child 1 on the following sessions

Thurs 29 July (5.45pm - 7.45pm)

Thurs 5 Aug (5.45pm - 7.45pm)

Thurs 12 Aug (5.45pm - 7.45pm)

Thurs 19 Aug (5.45pm - 7.45pm)

Thurs 26 Aug (5.45pm - 7.45pm)

All future SAY sessions on a Thursday night

Only Summer Holiday sessions

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All future SAY sessions on a Thursday night

Only Summer Holiday sessions

Play Streets STOCKBRIDGE ACTION YOUTH / GREEN GUARDIANS

Summer Stockbridge Action Youth Booking Form

Question Title

* 1. Childs Details Please complete for each child

Question Title

* 2. Address Details

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* 3. Parent/Carer Contact Details

Question Title

* 4. Please answer the following questions for each child which includes permissions:

Question Title

* 5. Please provide details of any allergies or medical conditions we need to be aware of before giving them a packed lunch? If you leave this blank we will assume that there are no allergies.

Question Title

* 6. I give permission for my child’s photo to be taken as part of Play Streets and be used by ForHousing & Play Street partners on Social Media, press articles, internal articles etc..

Question Title

* 7. Please use this space to make us aware of any access of any additional needs your child or children may have.

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* 8. I would like to book Child 1 on the following sessions

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* 9. I would like to book all my children on the same sessions: If so, please just complete for Child 1 and we will duplicate for all other children on this form

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* 10. I would like to book Child 2 on the following sessions

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* 11. I would like to book Child 3 on the following sessions

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* 12. I would like to book Child 4 on the following sessions

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* 13. I would like to book Child 5 on the following sessions

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* 14. I would like to book Child 6 on the following sessions

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* 15. Any other comments?