Parent/Guardian Consent & Application Form
· I acknowledge that all participants will be responsible for making their own to and from the session or tournament
· I authorise the member of staff that has a valid emergency aid certificate on site to administer any emergency medical treatment, including signing a consent form on my behalf if required by medical services
· I acknowledge that members of staff are only responsible for participants whilst they are attending the session or tournament. They are however free to come and go as they please during the sessions, and staff cannot be held responsible for their welfare once they have left the site
· I acknowledge and accept that the football club or respective servants shall not have any liability in respect of any loss or damage to persons or property whilst in attendance on the applied sessions, and that the members of staff reserve the right to refuse admission
Rules of Respect: I agree to make every effort to make these sessions fun and enjoyable by:
· Avoid racist, sexist or abusive language or behaviour
· Not smoking or spitting during or around sessions
· Not participating under the influence of drugs or alcohol
· Respecting coaches, all members of staff and each other
ParticipantsName...... Age...... D.O.B……………………………………………………………………………………………
Address......
...... Postcode......
Participants Contact Number......
Emergency Contact Name, Number......
MedicalConditions......
Medication......
School/College Attended (if applicable)......
Albanian □ Asian □ Asian Pakistani □ Black African □ Black British □ Black Caribbean □
Ecuadorian □ Indian □ Mixed race □ Nepalese □ Polish □ Turkish □ White British □
White other □ other background □
We, the undersigned, accept and understand our duty under s.17 Crime and Disorder Act 1998 to consider the crime and disorder implications of our work. We agree to share information for the purpose of preventing crime, disorder and anti-social behaviour within this meeting and we do so with understanding and acceptance of the Reading Joint Protocol on Information Exchange and the principles of Data Protection.
Photographs or video may be taken during these sessions for publicity and monitoring purposes please tick if you give permission for the taking and/or publication of images of your child. □
I agree to the terms and conditions above
Participants Signature......
Parents Signature (If under 16)...... Date…………………..