Extra Mural Lessons Form – B-Active

Recruitment Form

School *

Class *

Name *

First

Last

Age *

Date of Birth *

Allergies *

T-Shirt Size *

Payment Selection *

Name *

First

Last

Contact Number *

Email Address *

Relationship to Player *

Name *

First

Last

Contact Number *

Email Address *

Relationship to Player *

Checkboxes *

I, the undersigned, indemnify the B-active coaches or any other staff members of any responsibility should my child be injured through his/her participation in the B-active programme or any other events. I agree to be responsible and make payment of services rendered by B-active. I agree to give ONE calendar months paid notice. I allow pictures/videos of my child to be taken during sessions and events to be posted on social media, should I not agree I will notify B-active in writing.I accept the Terms and Conditions as per this leaflet

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