MINOR INFORMA TlON & RELEASE FORM - page 2 I hereby certify and represent that I am the parent or legal

guardian of the below named minor child, and I am over 18 years of age and have read the foregoing and fully understand the meaning and effect thereof.

I NAME

OF MlNOR CHllD: JAMES SEXTON NAME: ROB TO PARENT OR LEGAL GUARDIAN NAMED BELOW: rDAUGfITER r STEP-SON

I AGE:

15

I CHARACTER

RELATIONSHIP ~ON rBROTHER rOTHER

r STEP-DAUGHTER

r SISTER

rNEPHEW

rNIECE

NAME OF PARENT OR LEGAL GUARDIAN: GARY SEXTON HOME ADDRESS:27 LA VENDER ROAD,CARSHALTON, SURREY TELEPHONE: 02Q.8.6473$31

PARENT ORLEGAL\GUARDIAN

SIGNATURE

GUARDIAN ON LOCATION: KAREN SEXTON TELEPHONE: 02086473531