Parent/guardian name *

First Name

Last Name

Your phone *

(###)

###

####

Child name *

First Name

Last Name

Parent/guardian approval *

By clicking this box and submitting this form, I understand that it is required under child safety policies where someone other than a parent or guardian is transporting my child, and confirm that I have the authority to grant the approval, and consent to transportation of my child, as set out in this form.

By clicking this box, I understand that I must detail any custody arrangements, restraining orders or other details that the Club should be aware of (if any), and if so, I will be required to provide the Club with appropriate documentation.

By clicking this box, I understand that I also have a responsibility to safeguard my child's safety and will not put the Club or any of its representatives in a position where they may be in breach of applicable child safety policies/guidelines.