FOOTBALL TOURNAMENT REGISTRATION FORM

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FOOTBALL TOURNAMENT REGISTRATION FORM

Activate Body and Mind in Partnership with Little Players Kirkby

To complete registration for the football tournament, you will need to complete the attached registration form in full for your team.

TEAM DETAILS

Football Team Name:

Coach / Representative Full Name:

Player 1 Full Name:

Players Postcode

Player 1 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 2 Full Name:

Players Postcode

Player 2 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 3 Full Name:

Players Postcode

Player 3 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 4 Full Name:

Players Postcode

Player 4 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 5 Full Name:

Players Postcode

Player 5 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 6 Full Name:

Players Postcode

Player 6 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 7 Full Name:

Players Postcode

Player 7 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 8 Full Name:

Players Postcode

Player 8 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 9 Full Name:

Players Postcode

Player 9 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 10 Full Name:

Players Postcode

Player 10 SEND or Additional Needs: *

YES

NO

Additional Information:

Player 11 Full Name:

Players Postcode

Player 11 SEND or Additional Needs: *

YES

NO

Additional Information:

Please select which date your team are registering for; *

U6 Thursday 2nd November

U7 Friday 3rd November

Activate Body and Mind take photographs / videos of children who attend our events / programmes to be used in our group publicity (including our social media pages, website, and any promotional material to support and promote future events and to help us continue to deliver free camps). Once we no longer need images for publicity purposes, we will delete them. Does Activate Body and Mind have permission to include your team?

YES

NO

If certain children need to be excluded from photos / videos – Please note names here:

Consent can be withdrawn at any time by emailing us at info@activatebodyandmind.co.uk

If consent is withdrawn, we will delete the photograph or video and not distribute it further

TOURNAMENT DATES

PHOTOGRAPH / IMAGES DISCLAIMER

ACTIVATE YOUR POTENTIAL

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