South Shields Let Them Play

Let Them Play Consent

We are now pleased to be able to offer confirmed places on our Let Them Play session . At present we are offering places at our Harton Sports centre, Harton Academy, NE34 6DL

Please could we ask you to fill out the following form to consent to your children taking part in our Let Them Play session. Once we have received this form it will secure your place. We do apologise that if you have multiple children you will need to complete multiple forms. Sorry.

Child's Name

First Name

Last Name

Child's Date of Birth

PLEASE NOTE AMERICAN SYSTEM SO MONTH FIRST AND DATE SECOND.

YYYY

Child's School

What does your child like most about playing?

How did you hear about us?

Parent/Carer Details

Parents Name

Parent's Mobile Number

Parent's Email

Occupation

Address

House/ Flat Number

Street

Town/ City

Post Code

Medical & Emergency Details

Please provide contact details to those provided above incase we are unable to reach you

Any Medical Conditions, Allergies or Special Needs

Any medication

Emergency Contact Relationship

Emergency Contact Name

First Name

Last Name

Emergency Contact Mobile Number

(###)

###

####

Membership Fees

Please tick the payment schedule you would like for your child should they decide to become a member of our evening sessions following their taster sessions, please note this is no obligation

Monthly Single Session (1 per week): £20.00

Monthly Multiple Sessions (2+ per week): £35.00

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

Let Them Play Consent

Quick Links

Follow Us