JEF Taster Booking

Parent/Carer Full Name

First

Last

Email Address

Mobile Telephone Number

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Postcode

Please select the taster session(s) you would like to attend

Child 1 – Child's Name

Child 1 – Date of Birth

Child 1 – Age

Child 1 – Any allergies, medical conditions or important information we should be aware of

Child 2 – Child's Name

Child 2 – Date of Birth

Child 2 – Age

Child 2 – Any allergies, medical conditions or important information we should be aware of

Child 3 – Child's Name

Child 3 – Date of Birth

Child 3 – Age

Child 3 – Any allergies, medical conditions or important information we should be aware of

Names of adults attending

Emergency Contact Name

Relationship to Child

Emergency Contact Telephone Number

Photography Consent

I give permission for photographs and/or videos to be used by Elysian for marketing and promotional purposes.
I do not give permission.

How did you hear about Junior Elysian Farmers?

3 conditions be

Additional Information (Is there anything else you would like us to know?)

Required Consent (Please tick to confirm)

I confirm the information provided is accurate.
I understand that Junior Elysian Farmers is a community programme and not a specialist SEND, therapeutic, childcare or alternative provision service.
I confirm my child is aged 6–12 years (or is a 5-year-old attending with a supervising parent/carer), and that I believe they are able to participate safely within a group environment, follow adult instructions and behave appropriately around animals.
I understand there may be horses, dogs, cats, goats, poultry and other animals on site and agree that everyone attending will follow staff instructions at all times.
I consent to basic first aid being administered if required and understand I will be contacted if further medical treatment is needed.