EASTER ATHLETICS CAMP

Suitable for juniors aged 8 to 14 years of age (Year 3 to Year 10)

Thursday April 15^th

9.45am-3.15pm

at Millfield School Track, Street

with Qualified Athletics Coaches

£15 for 1 day

Paul Chadwick - 01749 812420 chair@wellscityharriers.org.uk Competing as Wells & Yeovil at cross country – top junior team across the region; and as Yeovil & Wells at Track & field. Several Team GB athletes and many juniors in national rankings. See website.

ALSO on Tuesday Aug 3^rd & Wednesday Aug 4^th 2010

APPLICATION FORM 2010

Name:

Address:

Date of Birth:

Post Code:

Sex: F/M

Contact Tel:

E Mail (if any):

Contact Mobile:

Additional Emergency contact Name and number:

Name of emergency contact

Has your child any medical conditions? (allergies, illness or recent injury, etc) If YES, please describe below the action to be taken in an emergency or provide separate details

Family Doctor:

Doctor’s Tel No:

School:

School Year in 2009/10:

Name of any other friend attending:

Any previous athletic training? If yes, please describe

I would like to reserve a place on the following day(s) (please tick appropriate boxes)
I wish to attend on Thursday April 15^th (cost £15)
I wish to attend on Tuesday Aug 3^rd & Wednesday August 4^th (cost £25)
I wish to attend all three days (£35)
I include payment (Cheques payable to Wells City Harriers)
Signature
Date

Is there anything else the coaching team should know about your child?

Please return this form with payment to Wychcraig, Portway Hill, Lamyatt, Shepton Mallet, BA4 6NJ (Enquiries to 01749 812420)

Note: All sessions are run under the guidance of qualified UK Athletics coaches and by signing this form you agree to abide by the conditions set by the training camp, and give consent for personal details to be held by Wells City Harriers to be used for athletic purposes only. Photography and film may be taken during this event, which may be used only for publicity, newspapers, website, promotional display etc.