Dear Student

Now you are a student at the College and you are under 19 you have FREE admission to our exciting Student Activity Programme. This programme allows you to participate in a wide range of sports activities and non-sport workshops.

Before returning this form, please visit the student intranet to view the student activity programme and all the activities. You can access The Student Intranet by logging on using your Student ID and password.

To access the programme we ask students to maintain a minimum of 85% class attendance.

We endeavor to provide opportunities for all our students to participate regardless of race, gender, sexual orientation, disability and medical conditions.

Some of the activities are held on the College premises whilst others are at external venues in the local area.

Please read carefully the enclosed Student Activity Agreement & Information Form.

The attached Agreement and Medical forms should be signed by your parent/guardian and emailed back to studentengagementteam@cnwl.ac.uk

Yours Sincerely,

Diana Brown

Deputy Head of Student Services

For more information, contact a member of the Student Engagement Team

in the Student Services Office at Willesden or call: 0208 208 5000

Student Activity Programme Agreement & Information

Student Activity Vouchers:

You will need a Student Activity voucher to take part in any of the activities.

Vouchers are issued from September to June term time only.

Where to get your vouchers:

Online via the Student Intranet

Collect your vouchers weekly from the Student Services office at Willesden or front desk at Kings Cross

Collect your vouchers weekly at reception or from the LRC in Wembley Park.

Number of vouchers you are entitled to:

Students are entitled to 3 vouchers each week providing you maintain a minimum 85% academic class attendance.

Vouchers will be refused if you are involved in any of the following:

Abusive to any member of staff

Disciplinary procedures.

Withdrawn from classes or serving a College suspension.

Not maintaining your 85% academic class attendance.

Misuse of the Student Activity Programme (which may result in suspension from the programme).

Agreement

I have read and agree to the Student Activity Programme Information provided above.

I understand that failure to comply will affect my position on the programme.

I also understand that the College may contact my parent or carer/guardians (where necessary) if there are concerns during my time on this programme.

Please print your name: ………………………………………………………………

Student ID number: ……………………………………………………………………

Contact number: …..………………………………………………………………..

Student Signature:……………………………………………Date:………………….

Parent/Guardian Student Activity

Consent Form for Under 19s

Student Name.......................................................................................................................... (In full)

Student ID Number.............................................................................................

As part of the College’s student activities, some activities take place at external venues and full supervision is not always possible. If you are happy for your son/daughter to take part in unsupervised activities, please sign the agreement and this form should be emailed back to: studentengagementteam@cnwl.ac.uk

I agree to:

My son/daughter being placed in an environment that may be unsupervised (e.g. Sports Centres). I give permission for my son/daughter to leave the College premises at authorised times of the day to attend student activities. (Also in the evenings and at weekends)

On occasion’s photographs/film footage maybe taken for display and publicity purposes, in order for photographs to be displayed we require your consent.

Please tick appropriate box

I give permission for any photographs/film footage taken whilst taking part in the Student Activity Programme to be used in College promotional material

I do not give permission for any photographs/film footage taken whilst taking part in the Student Activity Programme to be used in College promotional material

Please print your name: ………………………………………………...

Relationship …………………………………………………………….....

Parent or Carer/Guardians Signature: …………………………………………….

Date: ………………..………………

Emergency Contact number:

My/Our emergency contact numbers are:

…………………….……………………..Home ……………………………………...………………Mobile

Confidential Medical Form

If you tick yes in any of the boxes below, we may ask you to get a letter from your GP. This form will be kept in a confidential file; information will not be passed to anyone without your consent. Members of the Student Engagement Team will see this form.

Do you currently have any of the following conditions?

(Please tick relevant box)

Yes	No

1) High Blood Pressure?

2) High Cholesterol?

3) Diabetes?

4) A history of Coronary or Circulatory disorder?

5) Asthma, Bronchitis or any other Lung condition?

6) Epilepsy?

7) Food Allergies

8) Disability - (please state)

…………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………

Are you:

9) Pregnant?

10) Recovering from illness or surgery?

Please state any other illnesses/ condition …………………………………………………..……….

……………………………………………………………………………………………………………...

Parent or Carer/Guardians Signature: ………………………………… Date:………………………..