Prudhoe Free Play Consent Form

Free Play Football Consent Form

We are now pleased to be able to offer confirmed places on our FREE PLAY FOOTBALL club in Prudhoe

Please could we ask you to fill out the following form to consent to your children taking part in the Club. Once we have received this form it will secure your place. if you have multiple children please add them to the same form. Unfortunately we are unable to accept children on site without a consent form.

At present we have-

Play Zone Eastwoods Park, Thursday nights 530-630 (5-8 year olds) 630-730 (9 years plus)

Please note these are not coached sessions but pick up games for children to play freely.

THERE IS NO COST TO ATTEND THESE SESSIONS.

Child's Name

First Name

Last Name

Child's Date of Birth

PLEASE NOTE AMERICAN SYSTEM SO MONTH FIRST AND DATE SECOND.

YYYY

How did you hear about us?

Parent/Carer Details

Parents Name

Parent's Mobile Number

Parent's Email

Medical & Emergency Details

Please provide contact details to those provided above incase we are unable to reach you

Any Medical Conditions, Allergies or Special Needs

Any medication

Emergency Contact Relationship

Emergency Contact Name

First Name

Last Name

Emergency Contact Mobile Number

(###)

###

####

Signature

Data Protection: Here at Active Future we take your privacy seriously and will only use your personal information to administer your account and to provide the products and services you have requested from us. Please click below for our full Privacy Policy. www.activefuture.info/privacypolicy However, from time to time we would like to contact you with details of other events and offers and with information such as newsletters and company updates. We will never pass your details on to any 3rd parties for marketing purposes. We may also, from time to time take photographs for marketing purposes, by ticking the box below you are providing your consent for us to do so. Safeguarding: It is your responsibility to ensure your child is dropped off and collected safely by a parent or guardian from the coach at any of our events (Sessions/Holiday Weeks etc), we will do our upmost to ensure this.

CONSENT

From time to time we may take photos and videos to show you what we have been doing or run live sessions. These may be shared on social media.

I Consent

I Do Not Consent

Free Play Football Consent Form

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