This form must be completed by the parent or guardian on behalf of someone aged under 18, or by someone aged 18 or more who is registering in their own name.
If completing on behalf of someone else, what is your relationship to that person? eg father, mother Name of the adult completing this form, if this is being done on behalf of child or young person Email * Gender * … Select one Female Male Prefer not to say Address * Please select all activities you are interested in:
Select all that apply.
Please indicate any medical conditions we should know about.
Emergency contact information *
Please provide a name and contact number of someone we can contact in case of an emergency
Are you happy to have your photograph taken whilst taking part in activities with St Pancras Community Association and to have your photograph displayed on our website which is available for the public to see? … Select one Yes No I give permission (please select all that apply) to be contacted via: I give permission for my registration form information to be accessed by SPCA staff and instructors: *
GDPR (General Data Protection Regulation) replaces the Data Protection Act from May 2018.
Where did you hear about the Wellbeing programme?