Registration: Wirral Trampoline Club

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Confidentiality: Details on this form will be held securely and will only be shared with coaches or others who need this information to meet the specific needs of your child.

Email *

Full name of participant *

Please indicate whether you are specifically registering for our SEN class (Saturdays, 9:15-10:00) *

Yes

Address, including post code *

Participant date of birth *

YYYY

Gender *

Male

Female

Non-binary

Other:

Primary Contact

Full name *

Relation to participant *

Contact number *

Second contact

Full name *

Relation to participant *

Contact number *

Permissions

Is the participant permitted to leave alone after classes? *

Yes

Please list names and relationships of all adults who are permitted to collect the student (e.g. Amanda - Mum, Frank - brother) *

Medical and Access Info

Does the participant have any physical disabilities, illness or conditions? Please give details.
*

Does the participant have any neurological or mental health conditions, or learning difficulties? Please give details.
*

Does the participant require any medication during trampoline classes? If the participant requires support to take medication during sessions, you must speak to a coach before their first session.
*

Are there any activities or exercises that the participant cannot take part in? Please give details.
*

Does the participant have any allergies? *

Are there any dietary requirements (including vegan/vegetarian/halal)? *

Is there anything else we should know to coach the participant safely and effectively?
*

Consent

Please read each statement and tick to confirm you have read and agreed. Read our Privacy Policy here. *

In the event of an emergency, I give permission for qualified coaches to administer first aid or other medical treatment as necessary.

I give permission for mine/the participant’s data to be processed by Wirral Trampoline Club in accordance with the uses set out in the Privacy Policy.

I give permission for Wirral Trampoline Club to photograph the participant for the purposes of advertising, marketing and promotion of the club, including but not limited to social media, club website and paper-based resources.

Required

Signature *

Date *

YYYY

Send me a copy of my responses.

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