Consent Form
Parent / Guardian form of consent for their child's membership. Please note, a separate form is required for each child
Child's Name
*
First Name
Last Name
Child's Age
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Parent / Guardian Name
*
E-mail
*
Phone Number
*
Format: 000 00000000.
Does this child have any allergies?
*
Please Select
Yes
No
If 'Yes', please give details below
Will this child be allowed to leave the club on their own when the session is over?
*
Please Select
Yes
No
Can photos or videos be taken of this child for use on the club's social media?
*
Please Select
Yes
No
I will ensure that my child is told what the rules of the club are
*
Of Course
Special Requests
Submit
Should be Empty: