This Girl's Ability Registration Form

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This Girl's Ability Registration Form - Charlton

Please complete the below information before attending a session for the first time.

In accordance with the provision of the Data Protection Act 2018 and GDPR, any personal data which is supplied to the This Girl’s Ability will be held in a secure location and used solely for the purpose of our project. The information provided will not be passed to any third party unless permission from you is sought and granted.

For further information regarding data protection please contact:
Nikki Fairbairn
Founding Director/Community Engagement Officer
M: 07518 671812
E: nikki.fairbairn@thisgirlsability.co.uk

Young Person's Name *

Young Person's Date of Birth (dd/mm/yy) *

Full address, including postcode *

School/College *

What is your young person's status? *

Student

Employed

Unemployed

Young Person's Disability *

Young Person's Medical/Allergies *

Please specify any additional information which will assist coaches in leading the session:

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Number *

Emergency Contact Email Address *

Secondary Emergency Contact Name

Secondary Emergency Contact Relationship

Secondary Emergency Contact Number

Secondary Emergency Contact Email Address

**IMPORTANT: read the following carefully**

Photographs may be taken during the sessions for promotional purposes (social media/flyers/newspaper articles etc.).

Are you happy for your young person to feature in This Girl's Ability promotional material?

Yes

I also provide consent for my images to be used by the following partner organisations (Please select if you are happy):

Charlton Athletic Community Trust

Charlton Athletic Football Club

Other CACT partners (such as Royal Borough of Greenwich)

Other CACT patrons or sponsors (such as ITRM Ltd)

This Girl’s Ability may wish to send you promotional material regarding forthcoming activities and events as a text or email.

Are you happy to receive such information?

Yes

I would like to receive marketing material from Charlton Athletic Community Trust via text or email:

Yes

This Girl’s Ability is committed to equality and access for all in its activities. For us to monitor who takes up these opportunities, we need to ask for some details:

What is your young person’s ethnicity?

What is your young person's faith?

Signature of Parent/Guardian/Support Worker or Member over 18 years. If completing electronically, please write your initials and surname. *

Date Completed *

YYYY

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