SPORTS CLUB MULTI-SPORTS ACTIVITY SESSIONS FOR PRIMARY SCHOOL CHILDREN 19th & 20th February 2nd April 9th & 10th April 28th & 29th May 9am-3.30pm £10 per day or £15 for two days Activities based on the brand new MUGA pitch. For advance bookings email [email protected] The disclosure form on the reverse must be completed and given to one of the Sports Centre staff on arrival. 0800 315 002 | www.grimsby.ac.uk GrimsbyInstitute | @gifhe This form must be completed and signed by the Parent/Guardian of each child for them to take part in a session. Suitable clothing must be worn, packed lunch, water bottle and sunscreen must be provided. Name:...................................................................................................................... Age:......................................... Address:....................................................................................................................................................................... ....................................................................................................................................................................................... ................................................................................................................... Postcode:............................................. Mobile:......................................................................................................................................................................... Day time contact number:................................................................................................................................... Medical details:......................................................................................................................................................... ....................................................................................................................................................................................... Please provide details of medical condition and medication taken Doctor:........................................................................................................................................................................ Contact number:..................................................................................................................................................... Please provide details of your family Doctor: ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... In the event of my child being injured I give permission for my child to receive medical attention. (please delete where applicable). Yes / No I give permission for my child to be included in photographs taken by the Grimsby Institute and the press. Yes / No Children must be dropped off at 9am and picked up no later than 3.30pm. Signed:......................................................................................................................................................................... Name of Parent/Guardian:................................................................................................................................... Date Attending:......................................................................................................................................................... 0800 315 002 | www.grimsby.ac.uk GrimsbyInstitute | @gifhe