Register – My Helm CIC

Registration Form

You must register before you are able to sign up to any of our clubs.

Please note that all your data are protected and only used for the preparation of workshops and clubs.
They will not be shared with 3rd persons without your written consent.

"*" indicates required fields

Parent/guardian or carers name*

First Last

Sibling child 1 (attending)

First Childs Name*

First Last

Date of Birth*

Age*

Gender*

Sibling child 2 (attending)

Second Childs Name

First Last

Date of Birth

Age

Gender

Sibling child 3 (attending)

Third Childs Name

First Last

Date of Birth

Age

Gender

Create Username

Username*

Password*

Enter Password Confirm Password

Strength indicator

Email*

Contact number*

Address*

Address line 2

Town/City*

Post/Zip code*

Country*

Please select taster start date (only if purchasing a taster session)

Your date can only be confirmed if it falls into our term dates.

Please state below if your child does or does not have any special educational needs or requirements.*

Yes

Please state your child's needs*

So that we can support your child in the workshops please give us a brief overview of what special needs they may have. If they have a formal or informal diagnosis please explain how it may effects the chosen activities. PLEASE SAY NONE IF THIS DOES NOT APPLY TO YOUR CHILD

Would you like us to email you about future events?*

Yes

Do you permit The HELM to take photos of you and your child for for us to use on The Helm promotional material?*

Yes

MY HELM CIC Waiver - ON BEHALF OF THOSE UNDER 16 YEARS OLD*

Please tick to acknowledge and accept below

• I am the parent/guardian of the child/ren listed above who is/are under 16 years of age. I consent to allow that/those child/ren to participate in activities organised by MY HELM CIC.
• I acknowledge the risk on their behalf. I confirm that I am responsible for the child/ren in my care and undertake to ensure that he/she/they undertake the Activities in accordance with the safety rules advised before each session.
• I acknowledge the risk on their behalf. I confirm that I am responsible for the child/ren safety of their possessions.
• I acknowledge that I am responsible for the safety & wellbeing of the child/ren named below before and after they attend My HELM. If my child is not emotionally stable and settled before attending MY HELM CIC it is my responsibility to not have them attend for the day’s session until they are considered ready to attend My HELM clubs.
• I acknowledge that the maximum permitted age for participation in the Activities is 7 years and 16 years for children with additional needs during ‘Sen’ session and confirm that the child/ren do/es does not exceed this age.
• I acknowledge that it is my responsibility to assess the suitability of the Activities & the multiple age group use for children in my care.
• I have signed a risk acknowledgement & waiver form as a participant in the Activities;
TO BE COMPLETED/ACKNOWLEDGED BY ALL
• I understand that MY HELM CIC do not assess the abilities of individual participants or the suitability of the Activities for use by individual participants. I further understand that all participants, parents and guardians must make their own assessment of whether the Activities are suitable for use by individual participants and individual participants ability to participate in the Activities prior to use.
• I understand that the Activities are used by multiple age groups at the same time and are not restricted to any one age group.
• I understand that the Activities are physically demanding and involves sand play and unpredictable surfaces. Some areas use light projection that may contain flashing lights.
• I acknowledge that with some Activities there is a risk of personal injury when undertaking such Activities and participation can result in injury if misused.
• I//he/she/they use the Activities entirely at my/their own risk.
• I acknowledge that participation in the Activities can result in personal injury including, but not limited to, friction burns, cuts, abrasions, bruising, muscle strains, twists, sprains, and accept that these injuries can occur through general use of the equipment and not always or necessarily as a result of defective equipment or negligence of the Company.
• I understand that I/he/she/they is/are responsible for my/his/her/their own actions and or involvement in using the Activities.
• I understand that MY HELM CIC do not provide direct one-to-one supervision of participants when using the Activities. I understand that MY HELM CIC do not provide one to one training or tuition to participants in all the Activities. I understand that if my child needs additional training or care due to neurodiversity or any other reason that it is my responsibility to decide if the environment is suitable for my child.
• In the unlikely event of an accident, or loss or damage to any personal effects, I acknowledge that the Company will not be liable for any direct or indirect loss, damage or injury arising from or in connection with the Activities (except for death or personal injury caused by the Company’s negligence) and I waive all and any claims against the Company in this respect.
• I acknowledge and accept that CCTV images of all entrants will be monitored and recorded throughout the premises for the purposes of crime prevention and public safety.
• I acknowledge that I (and the child/ren in my care if applicable)
have read and fully understand the above and accept the terms of participation freely and voluntarily without any inducement prior to signing/submitting this form.

All clubs will go within a short distance of the complex to visit the green space, the park, or field as part of the course program. They will be guided by the coach/leader and staff during this time. Please tick that you allow your child to take part in this activity.*

Yes

CONTACT US - Use this section to ask questions or relay any information. We will then reply to you directly through email.

Name of secondary person allowed to pick up child from My HELM CIC:

First Last

Please give name of a secondary contact that you give permission to pick up your child during or at the end of their club session. This may be a family member or friend.

Phone

Please give mobile number of a secondary contact that you give permission to pick up your child during or at the end of their club session. This may be a family member or friend

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