High Ercall Tennis Club

Trip and activity consent form

 

 

I do/do not (please delete as appropriate) give permission for my child:

 

_______________________________________________________ (child’s full name)

 

to attend the following trip/activity: __________________________________________

 

 

Signed			Date:
Name (please print)
Relationship to child
Address
Contact numbers:	Home
	Mobile
	Work
Email address

 

Further emergency contact details, if different from above:

 

Name (please print)
Relationship to child
Address
Contact numbers:	Home
	Mobile
	Work
Email address

 

Please use the box below to describe any special care needs, dietary requirements, allergies or medical conditions:

 

 

 

 

Please return this form to:

 

Name (please print)
Address or instructions for returning form

 

 

 

 

 

 

 

 

 

LTA Child Protection

T: 0208 487 7008/7116

M (24 hour): 07971 141 024

E: childprotection@lta.org.uk

www.LTA.org.uk/childprotection