Required

Millfield Multi-Activity Course

Ages 9-11 - Week 3, Summer 2024

Monday 12th August -  Friday 16th August 2024


Your Child's Details

Must contain a date in D/M/YYYY format
Genderrequired
Medical Information, AEN and Dietary Requirements

Disclosing this information assists us with staffing, grouping and ensuring the welfare of your child; it does not automatically exclude your child from a course. If we require further information we may contact you in confidence for further details.

In the event of an emergency staff will make every reasonable effort to contact a parent or legal guardian before permitting treatment to proceed as advised by the medical authorities present.

Please inform us immediately if any of this information changes after you have submitted your application form.

Does your child have any medical conditions?required
Is your child currently taking any medication?required
Does your child receive additional support at school for additional educational needs including behavioural issues?required
Does your child have any significant allergies (e.g. allergic to peanuts or pollen)? required
Does your child carry an Epipen (Epinephrine)?required

If yes, please ensure they bring two with them. One must be given to the Course Leaders/Coaches.

Does your child have any special dietary requirements (e.g. lactose free or vegan)?required


Parent/Guardian Details

e.g. Mr, Mrs, Miss, Ms​​​


Emergency Contact Information

Please provide us with two emergency contacts who must be contactable for the duration of the course.

Emergency Contact 1

Would you like to use the Parent/Guardian details listed above as Emergency Contact 1?If yes, we will use the primary contact number listed as the emergency contact number.​
If yes, we will use the primary contact number listed as the emergency contact number.​

Emergency Contact 2



Terms & Conditions

All bookings are subject to the Sports & Activity Courses Terms and Conditions which can be viewed here

Terms & Conditionsrequired


Course Payment

I agree to pay the total displayed below.

£255.00


By submitting this application form you acknowledge that from time to time we may send you news and updates from Millfield that we think will be of interest to you by post or e-mail. You can easily remove yourself from this mailing list at any time by e-mailing ‘unsubscribe’ to media@millfieldenterprises.com or by clicking the ‘unsubscribe’ button at the end of the newsletters that you receive by e-mail.

Submit your form and proceed to payment by clicking the button below. Please note, it may take a short time to go through to the payment page, please do not leave or close the page after clicking the button.

Payment Information

Please select a payment typerequired
Billing Addressrequired
Cardholder Namerequired
After you have made your payment through your Childcare Voucher provider, please email the proof of payment to finance@millfieldenterprises.com to secure your place. If we do not receive your proof of payment within 1 working day of your booking we may need to cancel your booking. We will contact you by email if this is the case. We can accept Childcare Vouchers from the following providers: PROVIDER ACCOUNT NO CARE-4: Account No. 12114440 COMPUTERSHARE: Account No. 20166227 CO-OP: Account No. 85115505 EDENRED/ACCOR: Account No. P21098683 FIDELITI: Account No. MIL081C RG CHILDCARE: Account No. 12230175217 SODEXO/ALLSAVE: Account No. 811656 KIDDIVOUCHERS: Account No. 123911 FAIRCARE: Account No. SMIL0619 ENJOYBENEFITS: Account No. B020958 Please reference the payment with the prefix MSE followed by your child’s surname. Your booking will be confirmed once we have received payment from your Childcare Voucher provider.
<p>You will need to contact a&nbsp;member of the Millfield Enterprises team via <a href="mailto:enterprises@millfieldschool.com" target="_blank">enterprises@millfieldschool.com</a>&nbsp;who will then provide&nbsp;instructions on how to make payment for the course.</p>