Social distancing form

Parent Name *

First

Last

Child's Name *

First

Last

Date of Birth

Mobile Number

Email *

I would like my child/client to participant in trampolining and understand there is an element of risk from close contact. The coach will maintain the 2 metre social distance as much as possible. However due to the participants needs the coach may need to go with in this distance. I am happy for them to do this *

Yes
No

I am happy as a parents/carer to be involved with supporting the participant on the trampoline *

Yes
No
N/A

I am happy as a parent/career to get on the trampoline and assist with physical handling if needed for getting on and off the trampoline and for safety reasons *

Yes
No
N/A

The coach may stand behind the participant holding onto their waist *

Yes
No

The coach may hold the participant's hand *

Yes
No

The coach may have the participant between their feet and bouncing *

Yes
No

The coach may help the participant on and off the trampoline *

Yes
No