Once you've booked onto a Wild Day, use this form to provide medical details for each child booked, but ONLY for YOUR OWN child/children.
This form has space for TWO children's medical details. If you have booked for more than two children, please complete this form, then an additional Medical Form for the remaining children.
If you're unable to complete this form online, please download a medical form here , complete and send to Frontiers, Path Hill Farm, Path Hill, Pangbourne, RG8 7RE.
If the child hasn't yet booked onto a Wild Day, please use the Booking Form first.
Your Email Address
Please enter a valid email address.
Child's Full Name
Please enter the child's name
Details of an emergency contact on day of event:
Name(*)
Please enter an emergency contact name
Relationship to Participant(*)
Please enter the relationship (e.g. mother)
Emergency Phone Number (s)(*)
Please enter a telephone number for emergencies.
Doctor's details:
Name(*)
Please enter the name of the child's doctor.
Number(*)
Please enter the doctor's telephone number.
Does your child suffer from any conditions requiring medical treatment?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Has your child been in contact with any contagious or infectious diseases in the last 3 months (or with anything that may become contagious)?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Does your child suffer from any allergies (including medication)?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Does your child have any special dietary requirements?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Has your child received a Tetanus injection within the last 5 years?(*)
Yes No Please provide an answer
Does your child suffer from Travel Sickness?(*)
Yes No Please provide an answer
Does your child suffer from any other relevant problems that we need to know about?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
If you are just completing this form for ONE child, then scroll down to the Other Information section below.
Otherwise, complete details here for a second child.
Second Child's Full Name
Please enter the child's name
Details of an emergency contact on day of event:
Name(*)
Please enter an emergency contact name
Relationship to Participant(*)
Please enter the relationship (e.g. mother)
Emergency Phone Number (s)(*)
Please enter a telephone number for emergencies.
Doctor's details:
Name(*)
Please enter the name of the child's doctor.
Number(*)
Please enter the doctor's telephone number.
Does your child suffer from any conditions requiring medical treatment?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Has your child been in contact with any contagious or infectious diseases in the last 3 months (or with anything that may become contagious)?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Does your child suffer from any allergies (including medication)?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Does your child have any special dietary requirements?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Has your child received a Tetanus injection within the last 5 years?(*)
Yes No Please provide an answer
Does your child suffer from Travel Sickness?(*)
Yes No Please provide an answer
Does your child suffer from any other relevant problems that we need to know about?(*)
Yes No Please provide an answer
If so, please give brief details.
Invalid Input
Other Information:
Invalid Input
Yes Please confirm
Please Note:
Packed lunch & a drink in a small rucksack
Warm old clothes, which you do not mind getting wet or muddy.
Gloves and woolly hat in cold weather, sun hat and sun cream if hot.
Long trousers, no matter what the weather, to protect from brambles & nettles.
Waterproof jacket (and trousers if you have them.)
Wellington boots – fantastic for mud or long wet grass.
Strong shoes, boots or trainers if the weather is very dry.
Children need to be at the designated drop-off point
by 10:25 a.m.
When picking children up, please be at the pick-up point in plenty of time.
Children's Activities 
