Heads UP Sussex Contact & Consent Form PLEASE COMPLETE ALL FIELDS   Your Child's Full Name Your Full Name   Are you the legal parent / guardian of this child? Your Address Your Telephone Contact Your Mobile Number Your Email Contact   It is important to provide an alternative contact in case of emergency. Please make sure this person is available on the day. Alternative Contact Person Their Address Their Telephone Their Mobile I agree to my child participating in the Heads UP programme in any or all of the activities described. My child is of sufficient physical fitness to participate in the course.I recognise that there are safety and behaviour policies set out by Heads UP with which my child is expected to abide.I recognise that the course has inherent physical risks, as a result of participating in outdoor activities;that Heads UP instructors and assisting instructors will not be liable to my child now or at any time in the future for any loss,expense,damage or claim that I might have against them for any personal injury or damage to my child's property as a result of such participation in the course. I agree to my child receiving emergency medical treatment,including anaesthetic as considered necessary by the medical authorities present. Please write "I agree" giving your consent, plus your full name       All text and images Attitude Matters 2008 © Sitemap