Membership Form

Once signed up children can attend ANY of our sessions

Please fill in the form below.
Or download a printable version.

Children will not be able to attend without a completed membership form, you can either complete below or complete on at a SPLAT session.

If you have already completed a membership form, you do not need to complete another

Child 1 Details

Name
What Is Your Ethnicity?
Address
DD slash MM slash YYYY

Permissions

Please tick

Medical Information

Is your child allergic to plasters?

Child 2 Details

Name
What Is Your Ethnicity?
Address
DD slash MM slash YYYY

Permissions

Please tick

Medical Information

Is your child allergic to plasters?

Child 3 Details

Name
What Is Your Ethnicity?
Address
DD slash MM slash YYYY

Permissions

Please tick

Medical Information

Is your child allergic to plasters?

Emergency Contact 1

Name(Required)

Emergency Contact 2

Name

Keeping you updated

SPLAT Staffs would like to keep you updated from time to time. How would you like to receive the latest updates and news? (please tick)

Once completed, you will receive a confirmation email within 48 hours.

If your child attends a SPLAT Session within 24 hours of completing an online membership form, you will need to complete another membership form at the session you attend.

This is because, we need up to 48 hours to check through your completed online form, to ensure all contact details are correct.

Any personal information that is gathered, is in line with our GDPR policy and is safely secured.

If you would like to request a copy of our GDPR policy , please contact us.