Registration form

Activity Camp Registration

Player full name

Birthday

Day

Month

Year

Age

Would you like to add another player?

Yes

No

Dates attending

If multiple days, add below additional days

Additional dates to be indicate as DD - Month. For example: 4th and 5th July.

Emergency Contact No.

Name & Relationship to player

Email

Are there any medical conditions we need to be aware of ?

No

If yes, provide details

Are there any disabilities we need to be aware of

No

If yes, please provide details

PERMISSIONS

Tick the options you wish to grant permission.

Give paracetamol

Call emergency services if necessary

Join our mailing list for future events and communication

administer first aid

post image on our social media pages

Signature

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Print name