PolySports Registration
To ensure the safety of your child, please read the following form carefully and fill out all required details.
Email address *
Child’s First Name *
Your answer
Child’s Last Name *
Your answer
Child’s Date of Birth *
MM
/
DD
/
YYYY
Ethniticity *
Required
School *
Your answer
Address *
Your answer
Parent Full Names *
Your answer
Home Phone *
Your answer
Mobile (s) *
Your answer
Emergency Contact *
Your answer
Emergency Contact Number (s) *
Your answer
Child's Medical Details / Allergies *
Your answer
Which location are you registering your child for? *
Required
Please select when your child will be attending the programme *
Required
How will your child get to and from the programme? (Please notify the instructor at all times of any changes made to the form of transport) *
I would like my child to participate in activities delivered outside of the PolySports venue *
I consent to my child participating in the PolySports programme. Whilst Harbour Sport exercises due care and employs risk management techniques in the delivery of Harbour Sport activities it will not be liable for injury, damage or loss which my child may sustain during the duration of the programme or to his/her property during any Harbour Sport activity. *
I consent to the use of my photograph, video, image, voice and quotations in promotional/educational/reporting material by Harbour Sport. *
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