Off-site event permission form: Roller Skating/Blading!

I, give permission for my young person(s) to be at Roller One (Shop F6, 172-210 Burwood Hwy, Burwood East, VIC 3151) with youth leaders Charlotte Pryor, Aaron Motts, and Dean Woods on Friday 19th September 2025 from 7:00pm – 9:00pm.

Parent/Guardian Name

 
Parent/Guardian Email

Mobile:

Name of Young Person(s)


Submitting this form is equivalent to signing a paper form.