Office Hours Phone (08:30 – 17:00): +44 (0)1603 309 970
Out of Hours, please contact the Centre direct
Grosvenor Hall +44 (0) 1233618250, Isle of Wight +44 (0) 1983875353, West Runton +44 (0) 1263838384,
Colomendy +44 (0) 1352811000, Staffordshire +44 (0) 19028444485, Dukeshouse Wood +44 (0) 1434602503,
Dearne Valley +44 (0) 1709771010, Overstrand +44 (0) 1263579373
international@inspiring-learning.com Kingswood.co.uk
Agent Group Consent Form
Please complete this form and send back to us by email to international@inspiring-learning.com
Name of Agency:
Name of Group (if applicable):
Dates of stay
Number of students: Kingswood Centre:
Who holds parent/guardian contact details:
Emergency contact phone number (24/7):
If there are individual children who are not able to participate in some activities please make a list below.
Any children not allowed to do certain activities:
Name
Activity
Please attach separately a full list of student and adult names including gender, date of birth and nationality on name
import spreadsheet.
Do you have any students in your group who require a disabled access room: Yes
No
If Yes, please provide details:
Party Leader Emergency contact details (out of hours) the mobile number needs to be one which will work in the UK:
In the event of an emergency during or before the group’s visit.
Name:
Tel No: Relationship to group:
Name: Tel No: Relationship to group:
I confirm that each of our accompanying adults (including drivers, where applicable) are over the age of 18, has a
police check or similar background check completed and is suitable for working with children.
I confirm that we have parental consent from all parents/guardians of the above group to allow them to take part in any
Kingswood activities.
Signed
Name
Date
Company stamp