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at Fort Regent with David £34.65 for the 9 week course. 3.45pm – 4.45pm

Trampolining For 7 – 9 year olds 2627

Wednesday 7 May – Wednesday 9 July (no class 28 May) at Fort Regent with David £34.65 for the 9 week course. 4.45pm – 5.45pm

Trampolining For 10 year olds and over 2628

Wednesday 7 May – Wednesday 9 July (no class 28 May) at Springfield with Martin £34.65 for the 9 week course. 3.45pm – 4.30pm

Football For 5 & 6 year olds 2629 2631

Wednesday 7 May – Wednesday 9 July (no class 28 May) Friday 2 May – Friday 10 July (no class 9 May and 30 May) at Springfield with Martin £34.65 for the 9 week course. 4.30pm – 5.15pm

Football For 7 year olds and over 2630 2632

Wednesday 7 May – Wednesday 9 July (no class 28 May) Friday 2 May – Friday 10 July (no class 9 May and 30 May) at Granville with Gianpaolo £30.80 for the 8 week course. 6pm – 7pm

Fencing For 8 - 14 year olds 2626

Monday 12 May – Monday 7 July (no class 5 May or 26 May) at Oakfield Sports Centre £23.10 for the 6 week course. 6pm – 7pm

Cricket for school years 3, 4 & 5 2633

Wednesday 4 June – Wednesday 9 July at Oakfield Sports Centre £23.10 for the 6 week course. 7pm – 8pm

Cricket for school years 6, 7 & 8 2634

Wednesday 4 June – Wednesday 9 July

Fun Activities for 7 – 15 year olds

at Fort Regent (Queens Hall) Every Tuesday and Thursday during term time from 4.30pm to 5.30pm

£2.40 per session – pay at reception Spinning for 12 – 15 year olds

with Sue at Les Quennevais Sports Centre Every Monday and Thursday during term time from 4.45pm – 5.30pm

£3.85 per session or free to active card holders – pay at reception

Education, Sport and Culture Sports Development Fort Regent, St Helier JE2 4UX Telephone +44 (0)1534 449617 Fax +44 (0)1534 449825 Email sport@gov.je

For further information please email sport@gov.je or visit www.gov.je/sport Find us on facebook at www.facebook.com/SportsDevelopmentJersey Tweet us @jerseysport


Child’s Name:

Date of Birth:

Home Address:

Post Code:

Tel. Day:

Tel. Eve:

Emergency Contact Name & Tel. Number: Email:

School Attended:

Please list allergies and statement of special needs, etc.):

I consent to my son/daughter’s participation. I undertake to see that my son/daughter is provided with the required clothing/equipment where appropriate. I permit my son/daughter to be transported in departmental minibuses. To the best of my knowledge, my son/daughter is medically fit to participate in the activities involved and I undertake to inform you in advance of any alteration to this position. I consent to my son/daughter being given emergency medical treatment. Please notify us in writing if your son/daughter is being collected from an activity by another adult or if your son/daughter is able to make their own way home. All courses have limited availability and are offered on a first come, first served basis. Early booking is advised. Sports Development reserves the right to cancel or amalgamate classes where necessary. Please note that requests for refunds must be made in writing to Sports Development at least one week before the course start date. Please list your course requests below. We are unable to process refunds under the value of £7.

Course Code

Activity Description

Amount

Method of payment: Cheques should be made payable to “Treasurer of the States”. Or Credit/Debit card number Valid From

/

Expiry Date

/

Issue No.

Name of Cardholder Cardholder’s Signature Parent’s Signature:

Date:

Please return to: Sports Development, Fort Regent, St. Helier, Jersey, JE2 4UX Data Protection Law (Jersey) 2005 The information provided by you on this form is required by the Sport & Leisure Division for the purpose of course enrolment and coaching requirements. Children’s information supplied by you may be disclosed to sports coaches. Financial details provided will be securely disposed of at the end of each course.

Summer 2014  
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