Thank you for wanting to book with us for Home Education sessions. We want to be able to provide the best experience for you and your child/children.

Please answer all the questions below. The information you provide will enable us to support your child/children in the best possible way.

Email *

Parents Name

Phone *

Emergency contact name

How many children are you booking on to Home Ed?

Child 1 Name

Child 2 Name

Child 3 Name

Child 4 Name

Child 1 Age

Child 2 Age

Child 3 Age

Child 4 Age

Do any of your children have SEND?

If yes, please provide details below:

Do any of your children have SEMH concerns?

Disclaimer

Children remain the responsibility of their Parent/Guardian and must be appropriately supervised at all times.

The site is an open one with members of the public able to access that areas that we may be working in. It is also a wild environment with water, trip and slip hazards that parents should be aware of.

Whilst all precautions are made to keep the areas used in as safe a condition as possible, due to the natural state of the woodland it is not always possible to clear everything.

Wild Minds will not accept any responsibility for any injury caused whilst in the woodland.

Please tick below to say you agree with this statement and accept full responsibility for your child/children.

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