3G Pay & Play Consent Form

This form is to be completed by a parent or guardian of anyone aged between 8 and 16 years old wanting to access the Pay and Play sessions at Coach Road.

Child First Name*

Child Surname*

Child Date of Birth*

Emergency Contact Name*

Emergency Contact Number*

Phone

2nd Emergency Contact Name*

2nd Emergency Contact Number*

Phone

I confirm that I give permission for my child to access the Pay & Play session and take responsibility for their behaviour and actions while using the facility or while on the complex.*

Send me a copy of my responses

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