Believe Sport- Services and sport for Children and Young Adults with SEND

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Believe Sport Consent form

Please fill out the following form
in order to participate in our activity.

First name

Last name

Email

Date of Birth

Do you give photo consent?

No

Yes

Does your child have any medical condition, illness, or injury?

No

Yes

If you answered yes to any question, please elaborate

Name of Guardian giving consent ?

I declare that the info I’ve provided is accurate & complete

Do you Authorise as a last result Staff may Physical Intervene to avoid any injury to your child ,staff and others ?(Team Teach ) * Required

Yes

No

Child's Allergies

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