Outdoor Activities Residential Project February 2015
Duke of Edinburgh’s Award
Netherton Village Hall
330a-332 Meltham Road
Huddersfield
HD4 7EX
Julie.martin@kirklees.gov.uk
Tel: 01484 222374
Dear Award Participant
To achieve your Gold Award, you need to complete an extra section – the Residential. This involves
spending 5 days and 4 nights away from home on a shared activity with people you’ve never met before.
Are you looking for amazing experiences, personal challenges and team development or simply the chance
to have a lot of fun?
Here at Little Deer Wood we have enabled thousands of people to scale the heights and reach the summit
of their abilities by offering thrills and challenges with adventure activities like archery, abseiling, climbing,
canoeing, bushcraft and mountain biking in beautiful woodland surroundings based in West Yorkshire.
With a friendly team who are second to none in their enthusiasm, skills, qualifications and experience, we
take pride in offering the highest standard of customer service.
The Outdoor Education Residential Project offers Duke of Edinburgh’s Gold Award participants the
opportunity to take part in a wide and varied programme of activities at Little Deer Wood Shepley Bridge
Huddersfield Road, Mirfield, WF14 9HR which is easily accessible by public transport.
The project will commence at 2.30 on Saturday 14th February 2015 and you will be free to leave at around
4.30pm on Wednesday 18th February
The cost of the five day residential will be £125, which includes all activities, meals and accommodation
which is in our woodland cabin. If you would like to book a place please send a cheque payable to Kirklees
DofE Award Trust with your completed booking form.
If you are ready for a 'real' challenge and happy to leave the comfort of your arm chair and get active this is
the residential project for you. During the week you will be stretched in lots of different ways and leave
with life long memories and a huge smile on your face!
Yours Sincerely
Denise Bedford
Denise Bedford MBE
Duke of Edinburgh’s Award Manager
Gold Residential Students Kit List
General:
Washing kit, toiletries & 2 towels, Torch with batteries, Indoor footwear (slippers or trainers) Warm sleeping bag, roll
mat/therma rest, Nightwear and underwear Plastic drinks bottle (1 litre is essential)
Sun block protection (at least factor 20-30) Change of clothing for evenings Small/medium lunch box
2 large polythene bags (strong dustbin liners)
Outdoor activity clothing: complete changes of clothing for the activities in addition to the
following items:
2 thick fleece jumpers or sweaters 3 Tee-shirts (some long sleeved if possible) 1 pair of ‘old’ trainers
2 pairs loose or track suit trousers 1 pair gloves/mittens Hat/baseball cap 3 pairs of thick socks 1 pair of shorts
N.B. Cotton stays cold when damp so on wet days and for water sports we recommend wearing fleece, nylon, wool,
or ‘thermal’ underwear next to the skin. These non-absorbent materials retain some insulation even when wet,
whereas a cotton Tee shirt or jeans can feel like you are wearing a cold, wet dishcloth!
Useful optional extras:
Do not buy these items specially; just bring them if you have them:
Hiking Boots and Wellington boots
Windproof, waterproof top
Windproof, waterproof trousers
Body warmer or padded jacket/ski jacket
Camera
Non perishable snacks
Money:
There is a small tuck-shop onsite which sells drinks & snacks. We often visit a local shop and an ice cream
parlour.
Outdoor Activities Residential Project February 2015
APPLICATION FORM
Name __________________________________ Date of birth _____________/_________/__________
Address
______________________________________________________________________________________
Post code _________________Tel. (home) _______________________ Tel.
(mob)_______________________
E-mail address ________________________________________________________
Contact(s) for next of kin during period activity scheme: Name __________________________________
Address _______________________________________________________________________________
Post Code ___________________ Tel. (home) _______________________ Tel.
(mob)___________________
D of E Award Group (If applicable) ________________________________
Do you consider yourself to be a disabled person?
Yes/No
Please give details of any medical conditions/disabilities - e.g. diabetes, epilepsy etc. or allergies.
Please give details of any current medical treatment, including medication.
_____________________________________________________________________________________
Date of last tetanus injection:
_____________________________________________________________________________________
Details of any special dietary requirements:
______________________________________________________________________________________
I have ensured that I understand that it is important for his/her/my safety and for the safety of the group that
any rules and instructions given by activity scheme staff are obeyed.
I undertake to inform the Leader of any changes in my health prior to the volunteering.
I am in agreement that those in charge may give permission for my son/my daughter/me to receive
medical treatment in an emergency.
Signature:
(Young Person)
Signature:
(Parent/Guardian) Date:
Date:
If you pay Income Tax and/or Capital Gains Tax, The Kirklees Award Trust can reclaim 28p for each
£1 you give. Please Tick this Box if you allow us your consent and fill in appropriately below. **
Name of Donor:
Address:
Project Name
Young People Service Team
Venue
The Duke of Edinburgh’s Award Kirklees
Outdoor Activities Residential Project February 2015
DofE Team
DofE Marina Project Shepley Bridge Marina
Huddersfield Road Mirfield WF14 9HR
Young Person Details *
First name :
Last name :
Date of birth :
Age :
Where did you find out about the project:
Gender :
Male
Female
Ethnicity : (Optional)
A1 Indian / A2 Pakistani / A3 Bangladeshi / A4 Asian (other)
Please circle
B1 Black African/ B2 Black Caribbean/ B3 Black Other/ C1 Chinese /
M1 Mixed Race-Asian/ M2 Mixed race-Black/ M3 Mixed Race-European/ O1
Other/ V1 Vietnamese/ W1 White UK/Irish / W2 White European/ Rather not say
Address *
Address1 :
Address2 :
County :
Postcode :
Home telephone :
Mobile telephone :
E mail Address :
Emergency Contact *
Name :
Telephone Number :
Relationship :
Additional Info
Employment/ School/College
:
Name of School / College :
Any Disabilities /
Medical Conditions:
Disability Details :
Supplementary Info
How do you get to the project
:
Journey Time :
Statement of Consent
1. I am aware these schemes are an open access** scheme that may include sports, recreational, arts and craft, advice
information and guidance, media, health and food related projects.
2. I confirm the details of the participant are correct.
3. I know of no medical reason why the Young Person named above should not take part in any activities.
If you do not agree to any of the following please delete as appropriate
4. I understand that this scheme may enable young people to gain accreditation and the participant wishes to be
considered for relevant Duke of Edinburgh/Millennium Volunteers/Mayors Award programs.
5. I understand during the scheme photographs and video footage will be taken and that images can be used for
promotion and evaluation.
6. I agree that information may be shared with relevant partner agencies, to secure help for young person named,
through available support and guidance.
Signature:
(Young Person)
Signature:
(Parent/Guardian) Date:
Date:
Data Protection Act 1998: The information you provide to Kirklees Metropolitan Council is necessary for project management,
development and audit, and also, when appropriate, to secure help for young persons through available support and guidance. It will be
used only for those purposes. The Young People’s Service may share it with other Council Services and Partner Agencies where this
is necessary for and consistent with the stated purposes. For the purpose of the Act the contact is The Information Access Officer,
Room 108 High Street Buildings, Huddersfield, HD1 2NQ