REGISTRATION FORM

To complete registration, parents / guardians must fill out all sections of the Registration Form. This is required for each child. This information will be stored securely. You will only need to complete this form on your first visit but it is the parents / guardians responsibility to ensure the information is kept current and up-to-date. Please return either by email or post to the address below

IMPORTANT INFORMATION

If your child requires medication to be taken whilst in our care, please complete our Medical Form.



CHILD’S DETAILS

NAME
DATE OF BIRTH
AGE
GENDER
 M    F
SCHOOL
ADDRESS



PARENTS / GUARDIAN DETAILS

TITLE
NAME
RELATIONSHIP
HOME TEL
MOBILE TEL
WORK TEL
EMAIL ADDRESS



MEDICAL INFORMATION

Child’s medical history including childhood illnesses which influence daily care (allergies, allergies to any medication, asthma, any other medical conditions)

If your child requires medication to be taken whilst at any of mylittleboarders clubs please complete and sign a medication form.

NAME & ADDRESS OF SURGERY
NAME OF DOCTOR
TEL NO



EMERGENCY CONTACTS

NAME PARENT / GUARDIAN 1
RELATIONSHIP
HOME TEL
MOBILE

NAME PARENT / GUARDIAN 2
RELATIONSHIP
HOME TEL
MOBILE



PERMISSIONS

EMERGENCY MEDICAL TREATMENT

I/We consent to any emergency medical treatment necessary, and authorise staff to sign any written form by consent required by the hospital authorities if the delay in getting my signature is considered by the doctor to endanger my child’s health and safety

Yes       No       Other

FILMING

During the session we usually have the opportunity to film your child to show you how they are progressing. The clip is usually in slow motion and lasts around 3 seconds long and focuses on your child. We send this clip via Dropbox to the parents of the children booked on that day and then it is deleted from our records. We do not use it for any other purpose (unless you give us permission) as we have a very strict Social Media policy.

Please tick the box below to confirm that you would NOT like your child to be filmed for this purpose.
If you do NOT tick the box we understand you are happy for your child to be filmed in a clip to be sent to you via Dropbox:

I/We DO NOT consent to my child be filmed at all during the day.



AGREEMENT

I/We agree to:
provide up-to-date information about my child including any update-to-contact details
collect my child promptly at the end of the booked session (see the times of your chosen club)
pay the outstanding amount a week before the Skateboarding Club begins
notify the staff in advance if any adult other than those specified in ‘Contacts’ is to drop off or pick up my child
inform mylittleboarders if my child is to be absent from a booking for any reason