Registration form
First name
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Last name
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Email address
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Phone number
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We might need to send last minute info about a class
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Password
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Repeat password
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Participant is confident around water. I am aware that participation in water sports / bouldering activities may involve strenuous activity. The participant is fit enough to take part. I will notify the centre of any changes to the information on
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I Agree
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Emergancy contact number
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*
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Emergency Contact Name
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Date of Birth (DD/MM/YYYY) Min Age 8
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*
. This is a required field
Does the participant have any medical conditions that will affect the activity? (Y / N)
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*
. This is a required field
Yes
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no
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Information on medical conditions that will affect the activity?
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*
. This is a required field
I agree that photos may be taken of me/the participant and can be used for future promotional material, including social media with the London Borough of Bexley.
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*
. This is a required field
Yes
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No
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Anti-spam
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Please type the word:
community67
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