Harby Holiday Club
Child's Name *
Your answer
Child's Age *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Emergency Contact Email *
Your answer
Dates Attending (please write in all dates) *
Required
IS the participant taking any regular medication? If so, for what reason? *
Your answer
Does the participant have any long term illnesses or injuries? *
Your answer
The participant may have photographs taken during activities which may be used in promotional material and publicity in conjunction with the programmes of Hurricane Sports, including its website. Please identify in the box below if permission is given or not. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.