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BLACKSPIDER

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Consent Form

Please Fill out the Form.

First Name of participant

Last Name of participant

parent/gardian name (if student under 18)

Address

Age

Phone (if under 16 add parent number)

Email (if under 16 add parent email)

Emergancy contact number

Photo /Video Consent *

Yes

No

Medical information

Your Signature (if under 16 add parents signature)

I agree to the code of donduct

Date

I agree to the risk assesment

I agree to the terms & conditions

Thanks for submitting!

Opening Hours

Mon - Fri

9:00am- 9:00pm

Saturday

9:00 am –3:00 pm

Sunday

9:00 am – 3:00 pm

Address: Adelaide Street, Bradford, BD5 0EA E-mail: blackspideracademy@gmail.com

© 2021 Black Spider Academy

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