Contact Name
Address
Child's Name

I agree to the above child being filmed or photographed during the activity, with the possibility that these photographs/media recordings may be used for publications or marketing publicity. Hartlepool United FC will take all steps to ensure these images are used solely for the purposes for which they are intended. Note: if consent is not given, Hartlepool United FC will not use any images.

I release Hartlepool United from any liability that may arise due to the publication of such information.

Parental Consent

By submitting this form you are nominating the above child for the opportunity for a Junior Poolie experience for our game against Scunthorpe on 26th December 2025

In event of postponement the experience will be transferred to an alterntive available fixture.