Junior's skater name and number. The number must be unique within the Sheffield Steel Junior Roller League.

Doctor's name, address and contact telephone number

Please enter the name(s) and relationship of the person(s) you nominate to collect your child. Please use a comma between names and put relationships in brackets. i.e. Jane Doe, (Mother) , John Smith, (Father), etc.

Please enter the word you nominate to be used to verify the identity of the person collecting your child.
We understand that from time to time you will need to make alternative arrangement for the collection of your child. In these circumstances we would ask the collecting person to quote this word.

Please details your child's additional needs considerations

Are you happy for you or your child's image to used for promotional reasons (i.e. appear on our website, print media, other publicity)