Far Post Sports and Activity

camp

OCTOBER SPORTS CAMP 2016, 24TH-28TH OCT

Applicant Information
Childs
Name:

DOB:
First

Last

Address:
Street Address

City

Phone:

Postcode

Email

Name of person collecting child _____________________________________________________________________

I would like to book the following days/week for my child __________________________________________________
I have enclosed a cheque payable to ASP fitness for the sum of ___________________________________________

Any medical conditions we need to know about_________________________________________________________

Any allergies of further information ___________________________________________________________________
Would you like to be on the mailing list for updates of future camps?

Yes

No

Disclaimer and Signature

I understand that ASP FITNESS or their employees are not under any liability whatsoever in respect of personal injury, loss or
damage however caused, whilst attending the sports camp. I consent to any emergency medical treatment required by my
child during their stay at the sports camp. I understand and acknowledge the conditions above and confirm that my child is in
good health and consider him/her fit to take part.
ASP fitness promote discipline, respect, fair play and anti-bullying.

Signature of
Parent/Guar
dian:

Date:

Please send cheques and completed form to:

Andrew Pearce
12 Domville Close
andyfarpost@hotmail.com
Whetstone
London

Mobile: 07869293337
Email:

N20 0LE