CONSENT FORM - CHILD

Please fill out the following form in order that your child can participate in our activities. If you have more than one child participating please complete the form for each child.

Child's First Name

Child's Date of Birth * required

Child's Last Name

Child's Gender

Ethnic Origin

Your Email Address

Your Address

Your Phone Number

Emergency Contact Details

School Name

School Year

Does your child suffer from a medical condition, illness, or injury?

Yes

Does your child suffer from any allergies?

Yes

Does your child take any medication?

Yes

Does your child have a disability?

Yes

Does your child have any special requirements that we should know about?

Yes

If you answered YES to any question, please provide further details.

I give consent for photography and/or video footage to be used on Sporting PB's website & social media accounts.

I give my consent that if an emergency medical situation arises, the organisation/club may act in administration of first aid and/or other medical treatment that in the opinion of the member of staff is neccessary.

I can confirm all details within this form are correct.

Date Form Completed * required

Thanks for submitting!

Please complete this form for each child attending our events.