Skates & Ladders - Skateboard and Rollerblade Lessons in London

5 Week Course

Child's Name *

Child's Age (5 - 13 only) *

Parent or Primary Contact

Parent or Primary Contact Number

Primary Contact's Relationship to Child

Secondary Contact

Secondary Contact Number

Consent to walk home alone?

Secondary Contact's Relationship to Child

Child Collection Password (So we know the person collecting the child is authorised)

Does your child have any allergies/medical information we should know about? *

Does your child have a learning disability? Let us know so we can make sure the instructors know. *

Additional Information

I have read and agree to the waiver above

Yes

Vineyard School: Skate Art Club