Number Nine Project – Sign Up

Participant Details

Full Name *

Address *

Date of Birth *

Dietary Requirements

Medical Conditions

Parent / Carer Details

Full Name *

Email Address *

Address

Telephone *

Emergency Contact Name and Mobile Number

Name and Contact Details of social worker

Image Consent

I agree that photographs/videos/recordings of the above named may appear in:Hand Of's promotional material e.g. flyers, posters etc.Hand Of's websiteHand Of's social media profilesHand Of's staff training materialsPublications/recordings for general releaseThe media e.g. newspapers, TV

Consent

I agree to: 1. my child taking part in the stated activity; 2. Hand Of keeping a record of this form for health and safety reasons; 3. Any medical treatment that my child may need to be given in an emergency. *I agree

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