Sports Course Form

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Sports Courses - Application Form

This application form cannot be emailed. Please print it out and return it to the address detailed below.

If you wish to book and pay for your sports courses on-line.

Your Details

Name :
Address :	Please enter details...
Postcode :
Emergency phone :
Age :
Date of Birth:
School/Club:
EMail Address:

Course(s) Chosen

Course :	Date :	Time :	Ref :
Course :	Date :	Time :	Ref :
Course :	Date :	Time :	Ref :
Course :	Date :	Time :	Ref :
Course :	Date :	Time :	Ref :

Please tick if you are claiming

Leisure Flex Card Discount : (Pass No. )

Family Discount :

I enclose fee of Cheques to be made payable to "Tameside MBC"

I understand that the organising authority carries public liability insurance and that all staff are registered and qualified. I have read and understood the conditions of booking and accept them.

Signature of Parent/Guardian

Ethnicity

(Please tick most appropriate)
White Mixed Asian or Asian British Black or Black British Chinese or other ethnic group

Does your child have a disability

Please print this form out and return to:
Tameside Sports Development Unit, Court House, Chapel Street, Dukinfield, Tameside SK16 4DT

Page last updated: 29 October 2007