East London Basketball Camp 2017
Event Timing: July 27th - 29th , 2017
Event Address: Mossbourne Academy, Victoria Park Road Hackney E9 7HD
Contact us on 07932043694 or elbc@eltbaptistchurch.org
First and Last Name
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Date of Birth
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Telephone Number
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School
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Home Address
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School Year
Please tell us any details of any special educational needs that the child named above has:
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Please indicate any allergies the child named above has (please include any medication required)
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Tshirt size (please state if this is in child or adult sizing):
Name of parent/carer (must be over the age of 18):
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Relationship to child named above:
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Parent/carer contact number:
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Emergency contact number and name if different from the named parent/carer above:
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Email:
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I do/do not give my permission for the child named above to leave the camp alone
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