'Have a Go' Activity Weekend Booking Form 'Have a Go' Activity Weekend Booking Form Confirmation DateWhich 'Have a Go' Activity Weekend are you planning on attending?(Required) Saturday 24 and Sunday 25 October 2026 Saturday 13 and Sunday 14 February 2027 Young Person DetailsYoung Person Name(Required) First Last Young Person Known asYoung Person Preferred Pronouns(Required) he/him she/her they/them Prefer not to say Other Young Person Home Address(Required) Street Address Town / City County / Area Postcode AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Young Person Date of Birth(Required) Day Month Year Accompanying Adult DetailsAccompanying Adult Details Name(Required) First Last Accompanying Adult Known asAccompanying Adult Preferred Pronouns(Required) he/him she/her they/them Prefer not to say Other Accompanying Adult Relationship to Young Person(Required)Accompanying Adult Home Address(Required) Same as Young Person Other Accompanying Adult Email(Required) Enter Email Confirm Email Accompanying Adult Phone(Required)Accompanying Adult DetailsAccompanying Adult Details Name First Last Accompanying Adult Known asAccompanying Adult Preferred Pronouns he/him she/her they/them Prefer not to say Other Accompanying Adult Relationship to Young PersonAccompanying Adult Home Address Same as Young Person Other Accompanying Adult Email Enter Email Confirm Email Accompanying Adult PhoneAccompanying Siblings (if applicable)Sibling 1 First NameSibling 1 AgeSibling 1 Preferred Pronouns he/him she/her they/them Prefer not to say Other Sibling 2 First NameSibling 2 AgeSibling 2 Preferred Pronouns he/him she/her they/them Prefer not to say Other Sibling 3 First NameSibling 3 AgeSibling 3 Preferred Pronouns he/him she/her they/them Prefer not to say Other Young Person Visual Impairment InformationIs the young person registered blind or partially sighted?(Required) Registered Blind Partially Sighted Any additional details?What eye condition(s) does the young person have?(Required)How does this affect the young person?(Required)Does the young person use any mobility aid? e.g. long cane or guide dog.(Required)Does the young person require a sighted guide?(Required) Yes No What is the young person's preferred reading format (e.g. standard print, large print, braille, audio)?(Required)Young Person Medical InformationDoes the young person have any additional medical conditions, illnesses, injures or allergies?(Required) Yes No Please list any additional medical conditions, illnesses, injures or allergies that the young person has that you think we need to be made aware of.(Required)Please list any medication prescribed which the young person will need take during the weekend.(Required)Is the young person able to self-medicate?(Required) Yes No Is the young person a wheelchair user?(Required) Yes No Please provide any information that you think may be relevant.Additional InformationDoes anyone else attending have any visual impairments? (i.e. Does the Accompanying Adult require adapted material resources, use mobility aids or assistance in navigating?)(Required) Yes No Please provide any information that you think may be relevant.(Required)Does the young person or anyone else attending have any special dietary requirements?(Required) Yes No Explain what dietary requirements are required and who for.(Required)If the young person is currently in education, what is the name and location of their school or college?List any V.I. Organisations that the young person is a member of.Does the young person have an EHCP or statement?(Required) Yes No EHCP or Statement Details(Required) Local Authority Next Annual Review If travelling by car, please write the vehicle’s registration number.What are the young person's hobbies and interests?(Required)How did you hear about the 'Have a Go' Activity Weekend?(Required)Parental Consent for Medical AttentionIn the event that any young person is injured during any activities, and their parent / guardian cannot be contacted, medical treatment may need to be administered.I give consent for my child to receive medical attention.(Required) Yes No Consent Full Name(Required)Date Day Month Year Parental Consent for PhotographyDuring the weekend, RNC may be taking photographs and video footage which may be used for promotional literature, including prospectus, website and social media.I am happy for my child to be filmed and photographed.(Required) Yes No Consent Full Name(Required)Date Day Month Year DisclaimersRegistered guide dogs are welcome at RNC. Unfortunately, this does not extend to buddy dogs as it's against our policy for them to be permitted anywhere on campus.(Required) I understand Please note that by completing this form your details will be held on our student record system and will be used for the purpose of administration, guidance and monitoring. As part of administration process we will send you information and communication relating to your application and admission. Please see our Privacy Policy on our website www.rnc.ac.uk/privacy-policy.(Required) I agree