| |
 |
|
| 'Juniors |
|
APPLICATION
FORM
|
| Name |
|
| Address |
|
|
|
| Contact Tel No:-
|
|
| AGE
..
DOB
MALE /
FEMALE
|
| DOES YOUR CHILD HAVE ANY MEDICAL OR
PHYSICAL CONDITION WHICH MAY PREVENT THEM FROM PARTICIPATING IN AEROBIC
ACTIVITY. Yes / No |
| IF YES PLEASE
GIVE DETAILS |
|
|
|
|
|
| I PARENT/GUARDIAN OF THE ABOVE
CONFIRM THAT THE INFORMATION GIVEN IS CORRECT AND GIVE PERMISSION FOR MY
SON/DAUGHTER TO PARTICIPATE IN TRAINING WITH GOOLE VIKING STRIDERS JUNIOR
SECTION. |
| Signed: |
Print: |
| Date: |
|
|
