Summer Camp Application Form | Bicester Athletic Club

Athletics Holiday Camp 2023 Application Form

Bicester AC Athletics Camp Application Form
For more information about our camp go to: https://www.bicesterac.co.uk/bac-athletics-holiday-camps/
Section A: Applicants Details.
I would like to apply for*
Easter Camp Options*
Summer Camp Options
Attendees Full Name*
First Middle Last
Is the attendee curently a member of Bicester AC*
Address*
Street Address Address Line 2 City County Post Code
Date of birth*
Day
Month
Year
What is the Attendees gender?*
Current school year*
Current School*

Section C: Medical Information.
Does the attendee have Asthma?*
Does the attendee have an inhaler?*
Will they have their inhaler at the camp?*
Does the attendee have any allergies?*
Please list their allergies*
Do they have an Epipen?*
Will they have their Epipen at the camp?*
Does the attendee have any learning difficulties (ADHD, SPD, etc)?*
Please list their learning difficulties and any information our camp leaders need to be aware of.*
Other Details:*
Please give details of any other important medical information (e.g. epilepsy, diabetes, etc.) that our coaches / young leaders should be aware of. Will the attendee be bringing any medication (e.g. hay fever, etc.) - if there is no information please put 'None'.
Section D: Emergency Contact Details.
Emergency Contact One Full Name:*
Full Name Relationship to Applicant
Emergency Contact One Phone Number:*
Emergency Contact Two Full Name:*
Full Name Relationship to Applicant
Emergency Contact Two Phone Number:*
Medical Treatment Authorisation:*
- Yes
Please tick yes to give your consent to emergency treatment being given to the named applicant on this form by trained personnel, as it may be essential at some time for authorised persons acting on behalf of Bicester AC to have necessary authority to obtain urgent treatment which may be required whilst at the summer camp.
Authoriser's Name*
First Last
Date*
Day
Month
Year

Section E: Attendee's Agreement.
Agreement:*
- Yes
By selecting Yes I agree to abide by: 1: the athlete codes of conduct. The clubs code of conduct can be found here www.bicesterac.co.uk/bac-club-information/codes-of-conduct/. 2: I agree that the club officials may take & publish photos (print / internet) of me for club promotional purposes. ( subject to the clubs safeguarding / photo policy which can be found here http://www.bicesterac.co.uk/bac-club-information/). 3. The camp rules which will be set out in the confirmation. 4. The Covid policy set out in the Summer Camp Codes of Conduct – Polices – Legal. 5. Data provide in this form will be stored and used in-line with Bicester AC's data protection policy.
Applicant's Name:*
First Last
Agreement Date:*
Day
Month
Year
Section F: Parent / Carer Agreement:
Agreement*
Please select appropriate. By selecting Yes I agree : 1. To the named attendee taking part in the activities of the summer camp. 2. I agree that the club officials may take & publish photos (print / internet) of me / my child for club promotional purposes. (subject to the clubs safeguarding / photo policy which can be found here http://www.bicesterac.co.uk/bac-club-information/). If you do not want the attendee to be photographed and used inline with the clubs policy, please notify the club. 3. Data provide in this form will be stored and used in-line with Bicester AC's data protection policy.
Parent / Carer's Name:*
First Last
Agreement Date:*
Day
Month
Year

Bicester AC Athletics Camp Application Form