Junior's Name *

Age *

Adult Contact Name *

Email *

Mobile Number *

Are these also the details to use in the event of an emergency on the day? *

Emergency Contact Details

If the answer to the previous question was No can you please provide the name and number of an emergency contact.

Medical/Health Information - Please let us know if your child has any medical conditions, medication requirements or allergies or anything else we should know

Photography & Video - Consent Do you give permission for your child to be included in photographs or video footage taken during coaching sessions for use on club social media, website, or promotional materials? *

Yes, I give consent
No, I do not give consent

First Aid & Emergency Care - Do you give permission for qualified personnel to administer first aid to your child if required during a coaching session? *

Yes, I give consent
No, I do not give consent

In the event of an emergency, do you authorise the coach or responsible club official to seek appropriate medical assistance on your child’s behalf? *

Yes
No

Supervision & Collection (Optional depending on age group) Is your child allowed to leave the session unaccompanied at the end?

Yes
No, they must be collected by a parent/guardian

Data Privacy (GDPR) - I consent to the club storing and using our personal information for the purpose of administering the coaching programme, in line with the club’s Privacy Policy. *

I consent

Medical Disclosure Confirmation - I confirm that all medical information provided is accurate and that I will inform the club of any changes prior to future sessions. *

I agree

Parent/Guardian Declaration - I confirm that all information provided in this form is accurate, and I give permission for my child to participate in the junior coaching sessions. *

I agree

Price *

Price: £50.00

Total

£0.00

Stripe Credit Card *

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