Name

Address

Home Phone

Mobile Phone

ICE Number (relative or friend to contact in case of emergency)

Email

Birthday (DD/MM)

Chosen Royal Name

Do you give your permission for chapter photographs in which you appear to be displayed on our website?

Yes
No

Please read and tick the check box below

User Agreement

In submitting this form, I confirm that I understand and agree that my participation in any events, programmes and trips organised, operated and conducted by the 'Milton Keynes Scarlet Sparkles' Chapter of the Red Hat Society is entirely at my own risk.

I agree not to sue, and further I agree to indemnify and save harmless the members of the above named chapter from any and all claims, debts, actions and liability which may arise directly or indirectly from participating in any or all events, programmes, trips and activities for any loss, injury, death or damanges, however caused or arising.

I understand the risks and accept the terms and conditions which apply to my being a member of the above chapter. I understand that the events in which I take part, wherever they may take place, are entirely at my own risk.