Get in touch

Please drop us a line using the form opposite or ring us on 01872 885779 

Name *
Name

Park Farm
Truro
TR1 1SX

+44 (0) 1872 885779

Inspiring and educating children about sustainability and the natural environment through exciting hands-on experiences including school camp, summer camp, workshops and forest school. Based in Cornwall, our focus is green education, and our mission is to reconnect and engage children with the natural world, inspiring them to live more sustainably. 

Birthday medical dietary and consent form

 

Please complete and submit the medical, dietary and consent form below. To view the risk assessment please click here

Parent/Guardian Name *
Parent/Guardian Name
emergency contact information
Emergency contact 1
Emergency contact 1
Emergency contact 2 *
Emergency contact 2
Your child/ren
Child 1 name
Child 1 name
Please provide details of relevant medical history, medical conditions and medication which your child will require during camp
Child 2 name
Child 2 name
Please provide details of relevant medical history, medical conditions and medication which your child will require during camp
Permissions
Consent to take part in activities
Please check the box below to confirm that Camp Kernow have provided a risk assessment detailing the risks involved in the activities they provide, and that you understand those risks and accept them as part of the activity’s enjoyment.
Consent to medical treatment
Camp Kernow will contact you before the commencement of any medical treatment, unless your child's condition is such that immediate treatment is required before contact with you can be made. Please check the box below to confirm you authorise Camp Kernow to consent to any X-ray, examination, anaesthetic, diagnosis, treatment, and/or hospital care that may be recommended for your child/ren by a licensed physician or dentist.
Photo permission *
We may wish to take photos of children during their stay for use in Camp Kernow's promotional material. Please advise us in the box below if you are happy for your children to be included.
Social Media Permission *
We like to keep parents posted on life at camp via our Facebook page www.facebook.com/campkernowfriends, Instagram and Twitter feed www.twitter.com/campkernow. Please advise us in the box below if you consent to your child's photo appearing on Camp Kernow's social media.
Consent to administer medication
Please check the box below to confirm your authorisation of Camp Kernow staff to administer first aid and (where applicable) your child/ren's prescription medication as prescribed by a physician.
Please use this box to share with us any further information
i certify that the above information is correct to the best of my knowledge
Please type your name in full and check the box below to 'sign' the form
*