| Bulwell Outlaws BMX Club | ||||||
| Parental Consent Form | ||||||
| 2008 | ||||||
| Surname | Forename | |||||
| Home Tel Number | ||||||
| Address | ||||||
| Mobile Tel Number | ||||||
| Date of Birth | ||||||
| Postcode | School Year | |||||
| Medical Conditions | ||||||
| School | ||||||
| I understand that BMX Racing is a dangerous sport and that it is the rider's responsibility to wear the correct safety equipment. Long sleeves and trousers, gloves and a full face helmet are mandatory and elbow and knee pads are recommended. | ||||||
| Signature | (Parent |
or guardian) |
||||
| G P | ||||||
| DATA PROTECTION ACT 1988 | ||||||
| Bulwell Vision may use this data and take photographs in order to publicise activity for partners and | ||||||
| agencies associated with funding streams. Bulwell Vision may contact you with information regarding | ||||||
| their programme/ activities/workshop. Your co-operation is entirely voluntary and any information | ||||||
| given will be treated in the strictest confidence. Please tick to confirm you have read and agree to | ||||||
| this statement | [ ] | |||||
| Emergency Contact Number | ||||||
| Name | ||||||
| Address | ||||||
| Contact No | ||||||
| Name | ||||||
| Address | ||||||
| Contact No | ||||||
| www.bulwelloutlaws.co.uk | ||||||