REGISTRATION & CONSENT FORM
Cost? - Buncrana Team registration: €5 Individual registration: €1 | Derry: Team registration: £5 Individual registration: £1 | Pay on the day. 
Who? There are 2 age brackets: 13-15 years & 16-18 years. Every team will consist of 5 players and a maximum of 3 substitutes.
When? = June: Buncrana, Monday 24th, 3PM - 6PM | Derry, Tuesday 25th, 5PM - 8PM
Where? = Monday: Buncrana Youth Club, Castle Avenue, Buncrana & Tuesday: Bay Road Soccer, Bay Road Business Park, BT48 7SE
Contact: Buncrana: Oriel O’Gorman at 087 413 9476 or oriel.ogorman@gmail.com | Derry: James Wilson at 07963 601115 or info@derryfellowship.ie

Derry Baptist Fellowship have stringent child safeguarding policies in place to protect the youth and the volunteers.
Sign in to Google to save your progress. Learn more
Which tournament are you registering for?   *
First Name *
Surname *
DOB *
MM
/
DD
/
YYYY
Address *
Give details of any allergies or medical conditions.
*
Parent/Guardian Information
First Name & Surname  *
Relationship with young person  *
Phone number *
Email *
Will you be attending with your young person?  *
Required
Pictures/video are sometimes taken. Can your young person be included in this? *
AGREEMENT 

1. I allow my young person  to participate in this football tournament. 

   

2. I understand that in the event of any illness or accident, every effort will be made to contact me. However, if this is not possible, I authorise the leader in charge to sign on my behalf any written form of consent required by the medical authorities. 

 

3. I confirm that all information in this form is accurate and true to the best of my knowledge.

 

4. PRIVACY & DATA PROTECTION CONSENT

Your privacy is important to us, and we want to ensure that your data is held in compliance with EU GDPR regulations as of May 25th 2018. As a result of this new legislation, we need your consent on how we contact you. Your data will not be shared with a third party for any reason.

By signing this form you are confirming that you are consenting to Derry Baptist holding and processing your personal data to be used for Derry Baptist purposes only.


*
Required
Parent/Guardian Signature *
Date Signed  *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report