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: MF

School:

Address of the school

PARENTS / GUARDIAN DETAILS

Title: MrMrsMs

Name*

Relationship*:

Home tel

Mobile n°*

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 n°

EMERGENCY CONTACTS

Name parent* / Guardian 1*

Relationship*

Home tel

Mobile n°*

Name Parent / Guardian 2

Relationship

Home tel

Mobile n°

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

YesNoOther

AGREEMENT

I/We agree to

Terms and Conditions View

To accept all the matters, including all the risks, responsibilities and obligations, to with the Disclaimer refers View

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

 

* required

 

A copy of this form will be sent to the parents / guardian email address