LOOK UK and Jamie's Farm Activity Week - Application Form

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Jamie's Farm logo (left) and LOOK UK logo (right)
All information collected in this form is stored confidentially and solely for the use of accommodating all possible needs of participants and to identify staffing needs. It is important that you read the questions carefully and answer as honestly as possible.
Please note that completion of this application form does not guarantee your place at the activity week.
A member of LOOK staff will be in touch with you in due course to discuss your application.
Personal details:
Please complete these details as/on behalf of the young person applying to attend the activity.
























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Medical Details












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Independence Skills
Please indicate your level of independence in the following areas by selecting your response and giving details of any assistance required.











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General Information
To help us plan our activities and staffing levels, please describe your ability in the following areas






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Declaration, Privacy and Consent