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. 

Medical dietary and consent form

 

Please complete and submit the medical, dietary and consent form below.

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
Is your child a confident swimmer *
Child 2 name
Child 2 name
Please provide details of relevant medical history, medical conditions and medication which your child will require during camp
Is your child a confident swimmer
Child 3 name
Child 3 name
Please provide details of relevant medical history, medical conditions and medication which your child will require during camp
Is your child a confident swimmer?
Permissions
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.
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.
Photo permission *
We may wish to take photos of children during their stay for use in Camp Kernow's promotional material- both print and online. Please advise us in the box below if you are happy for your child/ren to be included.
Website & Blog Permission *
We will post photos and news of each day's adventures on our blog. Please let us know if you are happy for your child's photo to appear on the blog (NB names will not be published).
Social Media Permission *
We like to keep parents posted on life at camp via our Facebook page www.facebook.com/campkernowfriends, Instagram feed www.instagram.com/campkernow1 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.
Please use this box to share with us any further information e.g. if your child is coming with friends who they would like to share accommodation with.
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
Signature checkbox *