SSE Wildcat Girls Football Registration - Brackley Town FC Player Development Centre

SSE Wildcats Girls Football Registration

SSE Wildcats Girls' Football Club - Girls aged 5+ - Consent Form

Should you have any issues using this form please contact mike@brackleytownfc.co.uk

Young Persons Name(*)

Please specify name

Young Persons DOB(*)

Invalid Input

Name of the Parent/Carer(*)

Invalid Input

Emergency contact number of the Parent/Carer(*)

Invalid Input

Second contact number(*)

Invalid Input

E-mail address of the Parent/Carer(*)

Please specify your email address.

Please make sure you enter your correct email address, you will not receive confirmation details otherwise

Any medical condition/needs of the young person (including specific requirements of self-medication)(*)

Invalid Input

Does the young person have any access needs? If yes please tell us what we need to do to help them(*)

Invalid Input

Does the young person have any communication needs e.g. non-English speaker/hearing impairment/sign language user/dyslexia? If yes please tell us what we need to do to enable her to communicate with us(*)

Invalid Input

I give consent for The FA to use the contact details provided, to contact me regarding Women and Girls’ Football opportunities(*)

Invalid Input

I give consent for SSE to use the contact details provided, to contact me regarding Women and Girls’ Football opportunities(*)

Invalid Input

I give consent for BTFC to use the contact details provided, to contact me regarding football opportunities at BTFC(*)

Invalid Input

I confirm that my young person is not subject to family, care or legal proceedings. Please note that, if you are unable to say 'Yes' we will not photograph or film your young person’s involvement in the SSE Wildcats Girls’ Football Club(*)

Invalid Input

I consent to photography or filming the involvement of my young person in the SSE Wildcats Girls’ Football Club (Please select yes to signal your consent, in order to consent the above must also be answered 'Yes')(*)

Invalid Input

If you wish to find out more about The FA’s guidance on photography or other best practice issues please go to http://www.thefa.com/football-rules-governance/safeguarding/raising-awareness---downloads-section

I have read and understood the conditions of imagery use provided by The FA. (*)

Invalid Input

Please complete below as Parent/Carer

Name(*)

Please specify your mobile phone number.

Relationship to young person:(*)

Todays Date(*)

Invalid Input

Parent/Carer signature(*)

Sign Above

Invalid Input

For completion by the Young Person

Please read the SSE Wildcats Center commitment statment HERE

I consent to my involvement in SSE Wildcats Centre being photographed or filmed & I have read the SSE Wildcats Centre commitment statement above and will behave appropriately(*)

Invalid Input

Todays Date(*)

Invalid Input

Young person signature(*)

Sign Above

Invalid Input

Our Safegurading & Data Privacy Policies can be read HERE tick box below to confirm acceptance

I have read and accept Our Safeguarding and Data Protection & Privacy Policies(*)

Invalid Input

You will be added to our mailing list

BTFC Newsletters keep you updated on what’s new at Brackley Town FC including:

Latest team news - Football in the community news - Saints Community project news - And more

These Newsletters will normally arrive in your inbox at most once a month unless we have some urgent news that we think you might be interested in. There is an unsubscribe link on all newsletters, so you can unsubscribe at any time

Help prevent spam(*)

Invalid Input

Items marked with an * are required.