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Parental Consent

Strength and conditioning

As a parent/carer I understand the risk of any activity in the gym and accept all the risks and any outcome of those risks for my child, and give permission for my child to take part in YMCA Newark and Sherwood gym classes.


First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Medical Matters
Do any the minors listed on this form have any medical or are taking any medication, that you feel we should know about? (include all details about, Asthma, epilepsy, Diabetes if applicable)*
No
Yes

Please include below any details of any medicines being taken, any allergies e.g penicillin, plasters etc or any special dietary or other treatments necessary. Leave blank if not relevant. For children add the name next to the medication

Please Provide any other any information, including any disability/special/additional needs that the club should be made aware of and may help us make appropriate adjustments to support the child's needs.

Name of GP

GP Telephone number
Declaration of Fitness *
I declare that to the best of my knowledge; I do not suffer from any medical conditions which might have the effect of making it more likely that I would be involved in an accident which could result in injury to myself or others
Declaration of Fact *
I also confirm that the information provided is correct and if any information changes I will notify the centre
Privacy and General Data Protection Regulations

To comply with GDPR we are required to gain your consent to collect and store your personal Data. YMCA robin Hood Group is the data controller. We require your Data to ensure that you comply with the Terms and Conditions of use of the centre. We will store your data correctly and will not disclose to any third party. At any time you can request a copy of your data free of charge. GDPR, makes provisions for you to have your data erased and removed. This is known as the 'right to erasure/ right to be forgotten'. When the data is held for the establishment, exercise or defence of legal claims we have the right to refuse to erase the data. For this reason, our insurers insist that we continue to hold your data for 3 years from the date of your most recent visit.


In the case of Under 18 year olds, this is extended to 3 years beyond their 18th birthday. If you make a written request for erasure of your data, this request will be logged and the data will be erased after the period above.


I consent to the YMCA Robin Hood Group Privacy and GDPR policy.*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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