North West Leicestershire Sport & Physical Activity Alliance

If you intend to use Hermitage Leisure Centre please complete this form and your details will be sent to Hermitage Leisure Centre. You will still be able to use any of the leisure centres on the scheme.

* Required Field

Club Activ8 application form

Child's Full Name:

Address & Postcode*:

Date of Birth:

Club Activ8 card number*:

This will be start with CA

Home Telephone Number/Mobile*:

Marketing*:

Are you happy to receive relevant information from the leisure centres?

Email address if happy to receive emails:

Please select Yes/No if yes please complete the email field.

School Name*:

Please choose a school from the drop down list.