Bedford Modern School External Service - Bedford Modern School

Holiday Activities Registration Form
IMPORTANT - Please complete this form for each child - separate accounts are required, afterwards you can merge them together to form one login

Age of child at time of course beginning^*

This will not automatically update - you will need to update by hand with each booking

Does your child have any of the following conditions

If yes to any of the above please provide details

Please provide any details relevant to the courses

If yes please provide details of any medication required

Particularly if relevant to the courses or your child has an auto-injector

Are there any recent relevant illnesses / conditions of which we need to be aware

No
Yes

If yes, please provide details

Please remember to update this box for further bookings, particularly if no longer relevant

Do you give consent for the School Nurse to administer Paracetamol (Calpol) to your child if considered necessary

Yes
No

Do you give consent for the School Nurse to administer Anti-histamine to your child if considered necessary

Yes
No

Do you give consent for the School Nurse to offer suncream to your child if considered necessary

Yes
No

Miscellaneous Information

Please provide any additional information that you feel may be important to your childs booking

This could be medical, behavioural or general - in some cases we may need to ask for further information

Parent/Guardian Consent

In the unlikely event of an emergency arising in which it is impossible to contact you, do you give the school consent to act on your behalf

Yes
No

Photo Consent

During every course we take photos of the activities which we then use for publicity purposes including our next brochure, posters and website. Please note if you do not show a preference we will assume it to be yes.

Parent/Guardian Details

This will be the first point of contact

Alternative Emergency Contact Person

For use in an emergency only if we are unable to contact as named above

Future Brochures - Staying In Touch

If you would like to receive details of future courses please advise below. If you do not select an option we will not contact you regarding future courses.

Email Address^*

This will be your username and will be required when you log in to Wisepay.

Confirm Email Address^*

Please confirm your email address to ensure it has been entered correctly.

Password

##########

WisePay will automatically generate a strong password when this form is submitted. You will be sent an email to the email address entered above containing your log in credentials.

This challenge is to prevent automated systems from using this feature maliciously.
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Protection of Personal Data and GDPR legislation

Bedford Modern School External Service may ask you to provide personal data on this form. This data is stored by WisePay on behalf of Bedford Modern School External Service, to meet the legal obligations of a contract between WisePay and Bedford Modern School External Service. You are required to give your consent that this data can be processed by Bedford Modern School External Service.

Your Consent

I consent that this data can be processed by Bedford Modern School External Service.

Welcome to our Online Payment Area

Welcome to our Online Payment Area