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Name *

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Phone *

Your age *

Parent Information

Parent/Guardian 1 Full name *

Email of parent 1 *

Phone of parent 1 *

Parent/Guardian 2 Full name *

Email of parent 2 *

Phone of parent 2 *

In the event that one of the above named parents cannot collect the child, the named person / people bellow has my permission to collect the child ( must be at least 16 years old )

Does you child take any sort of medication that we should be aware of ? If yes, please specify. If no, enter N/A. *

Does your child have any allergies that we should be aware of ( example : face paints, plasters or food ) If yes, please specify. If no, enter N/A. *

Does your child have any other medical or additional needs that we should be aware of ? If yes, please specify. If no, enter N/A. *

PLAY endeavors to provide varied, fun, safe and physically active programs for youth of ages from 11-18. Obviously in any activities , accidents can occur. PLAY have a strict accident procedure to ensure all parents are fully informed of any accidents involving their child(ren). PLAY cannot be held liable for any costs incurred in seeking treatment recommended by a doctor following an incident, unless this was a direct result of negligence. These costs would need to be claimed via your family’s travel insurance. Please note that for the Safety and welfare of all the children PLAY regrets that ill children cannot be accepted into a club and the Club Managers reserve the right to refuse admission to a child if they believe they are ill or infectious. Before rejoining the club after illness, you may required to sign a declaration that your child is fit and healthy and can take part in the full program. PLAY will not accept a child whose behavior is antisocial or puts at risk their own safety or that of others. *

I agree

I give permission for my child to be photographed and or filmed for displays around the club setting and publicity purposes by the club venues. *

I agree

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