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PARTICIPANT DETAILS

PARENT/GUA DETAILS

EMERGENCY CONTACT 1

EMERGENCY CONTACT 2

GP INFORMATION

I have experience working with children

i am willing to help with kids club

I CONFIRM THAT ALL DETAILS DECLARED ARE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE. 

in the unlikely event of an accident, I give permission for a trained first aider to treat my child.  in an emergency were I or an emergency contact cannot be contacted: I give permission for my child/ward to be given hospital treatment including aesthetic if necessary.  I understand that every effort will be made to contact me.

photographs will be taken for publicity purposes.  should you wish your child's/ward's photo not be taken please tick here

I consent to the storage & use of my child/ward's email for the use of communication relating to events within xpression. 

This email acts as a Digitial Signature, by entering it and submitting the form this will be taken in good faith as the required permission needed to partake in Xpression.