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Online booking form

    Participant's details


    Please note that staff only have basic first aid training, so it is the responsibility of the participant/parent/guardian to arrange any medical safeguarding measures required.

    Parent or guardian details

    Only required if participant is under 16.

    Emergency contact

    Please note: Parents or guardians are responsible for arranging the prompt drop-off and collection of any child attending our sessions aged 16 or younger

    Programme*

    Please select the programmes you wish to book from the drop-down menu

    Photography or filming

    During activities, staff, authorised volunteers, consultants or partner organisations may take photographs and/or film parts of the session. Please indicate below if you/the participant consent to photographs or films being taken of you/the participant, and/or your/the participant's project work /art work, and authorise us to use, reuse, copy, publish, display, exhibit, reproduce and distribute the project/art work images in any educational material, merchandise (sold by The Wild Mind Project or trading arm Bon Feu), promotional materials or other forms of media without notifying you. All images will be shared with an Open Licence (creative Commons Attribution 4.0 International). Participants will not receive any payment from The Wild Mind Project CIC by giving consent or as a result of any publication or use of images.

    Liability waiver

    This waiver of liability includes any risk of attending The Wild Mind Project CIC programmes, events, workshops or other services provided by The Wild Mind Project CIC. The participant or their parent/guardian understand that:
    • these services are not offered as a substitute for clinical mental health care or medical care and are not intended to diagnose, treat or cure any mental health or medical condition
    • The Wild Mind Project CIC’s staff are not acting as medical professionals
    • participants are fully responsible for their wellbeing during the sessions, and subsequently, their choices and decisions
    • all comments and ideas offered by staff, volunteers, consultants or partner organisations are solely for the purpose of aiding participants in improving or enhancing their mental wellbeing and that participants or their parent or guardian hereby give such consent to staff, volunteers or partner organisations to assist participants in achieving such aims
    • where The Wild Mind Project CIC thinks it is in the interest of the participant’s well-being, we may contact an authorised safeguarding body to share relevant information

    The participant or their parent/guardian hereby release, waive, acquit and forever discharge The Wild Mind Project CIC directors, staff, volunteers, consultants and partner organisations from every claim, suit action, demand or right to compensation for damages claimed or that the participant may have arising out of their own acts or omissions, or acts and omissions of staff, volunteers, consultants or partner organisations as a result of any advice given otherwise resulting from The Wild Mind Project CIC’s relationship contemplated by this agreement. The participant or their parent/guardian further declare and represent that no promise, inducement or agreement not expressed in this agreement has been made.

    Zero Tolerance of Abuse Statement

    The Wild Mind Project operates a 'zero-tolerance' policy towards aggressive or abusive behaviour to staff, volunteers or other participants. This includes physical, verbal or written aggressive or abusive behaviour. The offender will be asked to leave the programme and may be reported to the police.

    Signing and consent

    By entering my name below, I hereby confirm that I have read, understood and agree to the contents of this form and The Wild Mind Project CIC’s safeguarding policy and privacy policy. I understand and agree that no oral or written representations can or will alter the contents of this document.

    If it is necessary for the participant to have a carer in attendance?

    YesNo



    Unfortunately, the venue is not suitable for wheelchair access.

    The Wild Mind Project is a not-for-profit organisation that works hard to raise funds to operate our programmes free of charge. In the current economic climate, it is increasingly hard to secure funding, so we would ask that if you are financially able, please could you donate £25 or more towards the cost of participating in one of our programmes - we would be truly grateful.