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Confirm
- Child's first name (*) Child's last name (*) Date of birth (*) Age (*) Medical problems / History (*) School attending (*)

I, , agree to my child taking part in Sylvestrian Leisure Centre’s Extreme Holiday Activities.

I give consent for medical treatment to be administered to my child on the advice of a medical practitioner.

I have set out above, or in an attached note, details of any medical condition from which my child is suffering, together with details of any treatment and medications currently being taken. I undertake to immediately notify the o rganisers of any changes to the notified medical status/condition.

By signing this form you are accepting our terms and conditions, including our behavioural Code of Conduct. Please see our website for details. www.sylvestrian-leisure.co.uk


Confirm
- Child's first name (*) Child's last name (*) Date of birth (*) Age (*) Medical problems / History (*) School attending (*)

I, , agree to my child taking part in Sylvestrian Leisure Centre’s Extreme Holiday Activities.

I give consent for medical treatment to be administered to my child on the advice of a medical practitioner.

I have set out above, or in an attached note, details of any medical condition from which my child is suffering, together with details of any treatment and medications currently being taken. I undertake to immediately notify the o rganisers of any changes to the notified medical status/condition.

By signing this form you are accepting our terms and conditions, including our behavioural Code of Conduct. Please see our website for details. www.sylvestrian-leisure.co.uk


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