‘AVIA Star Track’
[pic]New for Xmas Holidays.[pic]
‘Holmfirth Harriers’ Fun in Athletics Schemes 2020 For 6 – 13yrs of age
Monday 21st to Wednesday 23rd of December and
Tuesday 29th to Thursday 31st of December
at Holmfirth Harriers A.C Neiley Pavilion, Honley.
3 day course 10am to 3pm Daily
Fully supervised Lunch break.
Cost £30 for three day course, or £12 per day (Cheques to John McFadzean or by BACS with details on request.)
Forms available from John McFadzean (Mob 07800507824 or email j.mcfadzien@),
Registration forms to be sent to John McFadzean at 6 St Mary’s Mews, Honley Holmfirth HD9 6DH or by email to him.
Book early limited places available due to Covid Compliance!!! 30 Maximum.
• All participants will have temperature checked on arrival each day.
• Each coaching group will in a ‘bubble’ and remain so throughout the course.
• No changing rooms so participants need will require to be changed and have appropriate clothing.
• Each parent/guardian will be required to sign a Covid declaration prior to the start of the course if not previously completed.
Promoted by Holmfirth Harriers A.C in conjunction with Kirklees Council
ALL CHILDREN MUST BE PRE-REGISTERED AND HAVE THEIR PLACE CONFIRMED BEFORE ATTENDANCE
ACTIVITY REGISTRATION FORM
We are requesting the following information in order to:
Ensure that all participants are as safe as possible. Provide you with further information on opportunities available. Ensure that the activities are open to all the community.
ACTIVITY DETAILS
|ACTIVITY: |UKA Academy Star Track |Venue and Date | Monday 21st to Wednesday 23rd of |
| |Please indicate which activity you wish to attend with | |December 2020 at Neiley Pavilion |
| |dates if not full course. You may attend both. |One |Honley. |
| |Tuesday 29th to Thursday 31st of December 2020 at Neiley| |10am to 3pm each day. (Open from |
|Two |Pavilion Honley. | |09:30) |
PARTICIPANT DETAILS
|NAME: | |AGE: | |SEX: | MALE |FEMALE |
|ADDRESS: |
|POSTCODE: |
|TEL NO: | |DATE OF BIRTH: | |
|NAME OF PARENT/GUARDIAN/CARER: |
|Email Address |
| |
|EMERGENCY CONTACT NUMBER OF PARENT/GUARDIAN/CARER: |
|WHO IS AUTHORISED TO COLLECT YOUR CHILD FROM THE ACTIVITY SESSION: |
|THE SESSION FINISHES AT …3.00pm……………………….. AT THAT TIME YOU ARE RESPONSIBLE FOR THE CHILD’S WELFARE |
|ARE THERE ANY MEDICAL CONDITIONS THAT THE COACH SHOULD BE AWARE OF: |
ETHNICITY (PLEASE CIRCLE)
|WHITE |INDIAN |PAKISTANI |BANGLADESHI |
|CHINESE |IRISH |BLACK (OTHER) |BLACK CARIBBEAN |
|BLACK AFRICAN | |ANY OTHER (PLEASE STATE) |
DISABILITY
|DO YOU CONSIDER THE PARTICIPANT TO HAVE A DISABILITY (PLEASE CIRCLE) |YES |NO |
|IF YES, PLEASE STATE THE NATURE OF THE DISABILITY (PLEASE CIRCLE) | |
|LEARNING DISABILITY: |PHYSICAL DISABILITY: |
|HEARING IMPAIRMENT: |VISUAL IMPAIRMANT: |
|OTHER PLEASE SPECIFY: |
SIGNATURE OF PARENT/GUARDIAN……………………………………………………………….
DO YOU WISH TO RECEIVE DETAILS OF
ACTIVITIES IN THE FUTURE (PLEASE CIRCLE) YES NO
DO WE HAVE PERMISSION TO INCLUDE THE
PARTICIPANT IN PHOTOGRAPHS OF THE ACTIVITY SESSION YES NOLEASE
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