UNISON West Midlands Regional Games 2018
Saturday 21st July 2018
Holford Drive Community Sports Hub, 101 Holford Drive, B42 2TU

Contact for more info: wmsports@outlook.com or 07584 350039

All of your information will be securely stored in accordance with General Data Protection Regulations and not used for any purpose other than communication about the Games event.

Email address *
Complete section 1 of this form for Spectator tickets and section 2 for Activity wristbands
No limit to number of Spectator tickets you can request. For Activity registration only 1 person per form entry please.
Name *
Your answer
Phone number *
Your answer
How many free spectator tickets do you want? *
Your answer
Are you a UNISON member, employee, or friend/family? *
For members - what is your membership number and branch?
Your answer
For friends/family - which UNISON member or employee has invited you to this event?
Your answer
Section 2 - Participant Registration
PLEASE NOTE: *ALL* of the following questions must be completed for each person wanting to take part in activities at the Games. If registering multiple participants, complete the form fully for one person. Then start again with a fresh blank form for the next person. Parents/guardians may complete on behalf of children.
Participant name
Your answer
Date of birth
MM
/
DD
/
YYYY
Your gender
Your answer
Do you have a disability?
If yes, please specify any extra needs that you have
Your answer
Your emergency contact name
Your answer
Your emergency contact relationship to you
Your answer
Your emergency contact mobile number
Your answer
Do you have any past or current medical issues that we should be aware of? Including but not limited to: stroke, diabetes, epilepsy, hernia, dizziness & faintness, liver or kidney condition , any heart condition, high blood pressure, chest pains, arthritis, asthma. Please note: we are unable to guarantee that any sports activities are suitable for pregnant women.
If yes, please give details
Your answer
Do you want to take part in any of these activities listed below? (There are more activities happening on the day, but these ones need specific pre-registration for planning purposes. The activity wristband that we'll give you on arrival will let you take part in anything that doesn't need pre-registration.)
Tell us your 5-a-side Football team name (if applicable), or whether you need adding to a team. If not playing football, just put 'N/A' or leave blank.
Your answer
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