‘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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