This is the Response Form for Dorset Venture.  You will need to complete this once for each individual young person attending.  If the young person attending Dorset Venture is 18 years old, they may fill out this form themselves, otherwise we will need someone with parental responsibility to fill out the form for them.

Please set aside 10-15 minutes to complete this form in one sitting as it cannot be saved and later returned to.  When you press 'Submit' at the end, please wait for the confirmation message to appear, it begins 'Thank You'.  If you have any problems, please don't hesitate to get in touch!

Urban Saints complies with Data Protection Legislation. All of the data given on this form will be held and used in accordance with such legislation. Personal data will be held for the duration recommended by safeguarding authorities.  Where you grant permission below, relevant data will be shared with activity providers in order for young people to take part.  If you wish to change any consents given here, you can do so via the contact us page. Urban Saints full privacy policy can be found here.

Name of Young Person attending Dorset Venture: *
Name of Young Person attending Dorset Venture:
Name of person completing this form: *
Name of person completing this form:
It could be your name again if you're over 18 and filling this in yourself!
Young people often bring their mobile phones to camp. If they are planning to bring their phone, please enter their number below. This will only be used by a team member to contact the young person in the unlikely event of an emergency.
MEDICAL INFORMATION
From now on, all questions will be regarding the young person attending dorset venture, not the adult completing this form, thank you.
Is there any reason why he/she should not swim or take part in any sports or physical activities? *
Does his/her health require any special care? *
Is there any reason why he/she should not receive any normal treatments (e.g. due to allergies, objections to medicines)? *
Has he/she suffered any significant injuries or major illnesses in the last two years? *
Does he/she take any medication or drugs*? *
Does he/she have any special dietary requirements? *
Are you happy for staff to use adhesive plasters in the event of minor cuts and grazes? *
Are you happy for staff to administer Paracetamol to your child? *
Please include address and contact number where possible.
If the address given is not your home address, please indicate so and include your home address as well.
In an emergency, if I cannot be contacted despite all reasonable attempts to do so by the holiday staff, I give permission for my son/daughter to undergo emergency medical/dental treatment including the use of anaesthetics as considered necessary by the medical authorities. Please enter your name below as an indication of your consent to this.
Activity Waivers
This year on Dorset Venture we're hoping to take the young people along to two exciting new activities. To do so, we need to have permission to complete a waiver on your/their behalf. We have reproduced the text of both these waivers below, along with a link to the activities website so that you can see exactly what the activity is. If any young person does not want to participate, or if you do not give your consent for them to participate, they will stay with leaders in an observation area.
www.dorsetwaterpark.co.uk An inflatable assault course situated on a small lake, this supervised activity is lots of fun! WAIVER DETAILS Dorset Waterpark is an inflatable assault course spread over multiple lakes that also includes rope obstacles between trees. Participation involves swimming, swinging, slides and jumping from height. Dorset Waterpark is a physically demanding activity and accidental injury is possible. Possible injuries include cuts, grazes, sprains and bone fractures, but more severe injuries can happen including loss of consciousness or drowning. You must report any accidents / injuries to a member of staff. Some situations may cause feelings of discomfort and fear. Participants must be aged 6 or over and be more than 100cm tall. Participants must be able to swim 50 metres and be confident in the water. It’s very important that we know of any pre-existing health issues which may impact on your child’s participation such as Back/Neck Injuries, Diabetes, Epilepsy, Respiratory, Pulmonary, Psychological or other health considerations affecting a participant’s performance. You must inform a member of staff before your session if your child has any pre-existing health issues. If appropriate, inhalers and epipens must be with you child on their session. If you like any more information then please contact us prior to your session.
Any medical notes given on this form will be included on the waivers we complete for you/your child (assuming you have given permission); if there is anything else you would like us to include on the, please enter it here:
OPTIONAL EXTRAS
Would you be interested in doing any Optional Extra activities? All activities are offered on the basis that we must achieve a required minimum number of bookings to run.
Please tick all which apply. Payment details and information about each activity are included on the Final Instructions letter that was sent with the link to this form.
If the young person attending is under 18, we require parental permission for them to participate in any offsite activities they have booked for. Please indicate that you are happy for the young person to take part in the indicated activities by entering your name below, to indicate your consent and giving permission for the Holiday Leader to sign and complete any necessary paperwork relating to those activities. Thank you.
ARRIVAL
How will you be travelling to camp? *