Basic Information

Your full name Your child/childen's full name(s) Your child/childen's age(s) Which funtime trip(s) would your child/children be attending? Capstone Park - Friday 4th August 2023Capstone Ski Centre - Friday 25th August 2023Both Capstone Park & Capstone Ski Centre

Consent

I give permission for my child/children to participate in Lordswood Leisure Centre funtime trips. I understand they may be traveling to them by coach
Yes - I give my consentNo - I do not give my consent

Medical Conditions

My child/children have the following medical conditions and or/allergies, if this form is to be used for multiple children, please indicate which condition and/or allergy is for which child. In the event of a medical emergency, do you give consent for a member of staff to sign any forms on your behalf should the delay of obtaining a signature be considered inadvisable by the doctor? Yes - I give my consentNo - I do not give my consent

Emergency Contacts

Emergency Contact 1: Emergency Contact 1 Full Name Emergency Contact 1 Contact Number Emergency Contact 1 Relationship
Emergency Contact 2: Emergency Contact 2 Full Name Emergency Contact 2 Contact Number Emergency Contact 2 Relationship