Additional Information for Sport Zone Home / Documents / Sports Zone Additional Information Parents name * Participant/s full name * Does your child/children have any medical conditions we need to know about? * Who other then yourself has permission to pick your child/children up? * Is your child/children coming both morning and afternoon? * Morning onlyAfternoon onlyBoth Morning and afternoon Does your child require lunch time supervision? if so pay at www.sussexatplay.ca * YesNo Name of daytime caregiver * Phone of daytime caregiver * The Sussex Sports Zone staff has my permission to use my or my child’s photograph publicly to promote the program. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. * Yes, I give my permission. No, I do not give my permission. I understand and acknowledge that the Town of Sussex Sports Zone Program requires a responsible guardian be available for the daily care of my child and that this person is immediately available to retrieve him/her as required. * Yes I understand and acknowledge that the Town of Sussex is not responsible for an injury or accident during my child/children’s participation in the Sports Zone Program. * Yes, I understand the Town of Sussex is not responsible for any accidents or injury my child/children might sustain during the Sports Zone Program. Submit If you are human, leave this field blank.
