South Shields Free Play — Active Future

Expression of Interest Form

Please could we ask you to fill out the following form to express an interest in the Free Play Sessions. This form does not commit you to anything but provides us with information for safeguarding purposes. Once we have received your form one of our expert coaches will be in touch to confirm your child’s place(s).

Sessions are starting on Thursday 28th April from 5-6pm at Mortimer Community College, NE33 4UG and will take place every week following!

Parents Name

Parent's Mobile Number

Parent's Email

Child's Name

First Name

Last Name

Child's Date of Birth

PLEASE NOTE AMERICAN SYSTEM SO MONTH FIRST AND DATE SECOND.

YYYY

Any Medical Conditions

Does your child have any preferred sports?

How did you hear about us? (Please state name if referred by a friend)

Signature

Data Protection: Here at Active Future we take your privacy seriously and will only use your personal information to administer your account and to provide the products and services you have requested from us. Please click below for our full Privacy Policy. www.activefuture.info/privacypolicy However, from time to time we would like to contact you with details of other events and offers and with information such as newsletters and company updates. We will never pass your details on to any 3rd parties for marketing purposes. We may also, from time to time take photographs for marketing purposes, by ticking the box below you are providing your consent for us to do so. Safeguarding: It is your responsibility to ensure your child is dropped off and collected safely by a parent or guardian from the coach at any of our events (Sessions/Holiday Weeks etc), we will do our upmost to ensure this.

CONSENT

From time to time we may take photos and videos to show you what we have been doing or run live sessions. These may be shared on social media.

I Consent

I Do Not Consent

Expression of Interest Form

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