Premier League Kicks Witney Registration Form

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Witney ATP, Gordon Way, Witney, Oxfordshire OX28 4EH (Year 9 - Year 13) (13-18 Year Olds) - Wednesday 5:00pm - 6:00pm (3G Surface Footwear: Moulded boots & Astro Trainers)

Participant name (First and last name) *

Full home address, including postcode *

Date of Birth *

YYYY

School Year *

Gender *

Male

Female

Prefer not to say

Other:

Ethnicity *

Asian / Asian British / Other Asian background

Black / African / Caribbean / Black British / Other Black background

Mixed / Multiple Ethnicity / Other Mixed or Multiple ethnic background

White British / Irish / Gypsy or Irish Traveller / Other White background

Other ethnic background

What school do you attend?

Parent/guardian details - name *

Parent/guardian telephone number *

Parent/guardian Email Address
*

Secondary emergency contact - name and telephone number *

Medical information / Allergies *

Oxford United in the Community may want to take photos or videos of the team or players solely for the purposes of promotion and celebration. Please indicate if you are happy to be photographed or filmed? (or for your child to be photographed or filmed if under 16) *

Yes

Do you have a disability? *

No disability

Learning disability

Hearing impaired

Amputee

Cerebral Palsy

Partially sighted

Autism Spectrum Disorder

Down's Syndrome

Declaration - I (parent/guardian) confirm that I am happy for my child to attend these sessions *

Yes

Your Data

By completing this form you are consenting to us using your personal information for the purposes: Oxford United in the Community would like to collect data for monitoring and evaluation purposes and to safeguard participants. All personal data, including sensitive data*, will be processed fairly and lawfully. All data will be processed securely with appropriate controls in place. Data shared with 3rd parties to fulfil contractual obligations will be processed via secure email.

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