boltonwoodscommunitycentre

Adult Consent Form

First name

Last name

Phone

Email

Project

Emergency Contact Name.

Emergency Contact Number.

Address

Consent

I agree to The Bolton Woods Centre keeping record of this form for health and safety reasons.

I consent to being filmed or photographed during the activity. I understand that the photographs or film might be used on social media to promote The Bolton Woods Centre - NOTE If I do not agree to this The centre will not use any images of you.

Yes, subscribe me to your newsletter.

Signature

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Registered Charity No: 1200230

Adult Consent Form