Book a BUMBLEance - The Children's Ambulance Service

Parent / Guardian 1
Enter the details for the parent / guardian who is the main point of contact for the child.
Parent/Guardian Name*
First Last
Parent/Guardian Phone*
Parent/Guardian Email*
Parent/Guardian Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian Relationship to Child*
Child Photo / Video Consent
Sometimes photos are taken on the day of travel if your child wants a picture with his / her driver. Please tick below to give us permission to take photos of your child and use these in our printed and online publicity.
- I give permission to take photos and / or videos of my child. I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group’s aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications.

Parent/Guardian 2 Details
Enter the details of a second parent / guardian (optional) or select NEXT to proceed
Parent/Guardian 2 Name
First Last
Parent/Guardian 2 Phone
Parent/Guardian 2 Email
Parent/Guardian 2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian 2 Relationship to child

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Child Details