Easter 2015 web - Chesterfield Borough Council

Queen’s Park Sports Centre
Photography
I give permission for photographs of the named young
person undertaking the named activity, to be used
for publicity and promotion of childrens’ and young
peoples activities by Chesterfield Borough Council.
Yes
No
I consent to the named young person taking part
in the named activity (please note in order to give
consent you must be the named young persons parent,
guardian, carer or a relative over the age of 18).
Signed:
Date:
Prices and times
Full day:
9am-4pm.
Drop off 8-9am / pick up from 4-5pm.
£10.80 Active Chesterfield members
(£12.00 non members)
Half day:
9am-12noon / 1pm-4pm.
Drop off 8-9am / pick up 12noon/1pm
Drop off 12noon-1pm / pick up 4-5pm
£5.40 Active Chesterfield members
(£6 non members)
Multi sports activities will run alongside all
activities. All water activities come with a
dry side option.
A consent form must be filled in for each
child upon booking, without this they will
not be able to participate.
All activities must be paid for at the time
of booking. All activities are subject to our
terms & conditions and subject to change.
For further information
Queen’s Park Sports Centre
Boythorpe Road, Chestefield
S40 2ND
Tel: 01246 345555
www.chesterfield.gov.uk/queenspark
Active Easter
Easter holiday programme
Monday 30 March – Thursday 10 April
Activities for children aged 6-14 years.
Full day and half-day sessions available
Young persons
consent form
Name of Young Person:
Timetable
Day
Address:
Week 1
Monday 30 March –
Thursday 2 April
Monday (AM)
Gymnastics
Monday (PM)
Team Games
Tuesday (AM)
Arts and Crafts:
make your own armour
Tuesday (PM)
Fencing
Week 2
Tuesday 7 April –
Thursday 10 April
Date of birth:
Easter Monday – no activities
Emergency Telephone number:
Booking information
Actvity Course:
Make your own egg
(papier-mâché) competition –
winner will get an easter egg
Decorate your egg in afternoon
Multi sports played throughout the day
Wednesday (AM)
Rounders & Kwik Cricket
Dodgeball and Benchball
Wednesday (PM
Trampolining and open
tumbling with Crystal Cheer &
Dance
Netball / Basketball
Thursday (AM)
Water Polo
Dry side option available
Water Polo
Dry side option available
Thursday (PM)
Racquet sports
Trampolining and open tumbling with
Crystal Cheer & Dance
Friday (AM)
Good Friday – no activities
Gymnastics
Friday (PM)
Who do we contact in an emergency?:
Water Rave (age 8+ must be able to
swim 50 meters)
Dry side option available
Venue:
Date of activity start date:
Finish date:
Medical conditions/Special Needs/Allergies
Please write in the box details of any relevant medical
condition.
Please Note: our staff are unable to
administer any medicines to children
taking part in the sessions.
If you would like to be added to our mailing list
to recieve information on future activities at the
centre. Please provide your email below:
Email: _________________________________________________
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