Mentivity - Community Football Session Registration

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Please complete this form to register your child

Parent/Guardian Name *

Child's Full Name *

Ethnicity *

Arab

Asian/Asian British, Bangladeshi

Asian/Asian British, Chinese

Asian/Asian British, Indian

Asian/Asian British, Pakistani

Asian/Asian British, any other background

Black/Black British, African

Black/Black British, Caribbean

Latino

White and Asian

White and Black

Any other Mixed or Multiple ethnic background

White English/Scottish/Welsh/Northern Irish/British

White Irish

White, Gypsy or Irish Traveller

White, any other White background

Any other ethnic background

Prefer not to say

Prefer to self-describe

Ethnicity continued

Childs Age *

Childs Date of Birth *

YYYY

Emergency Contact Name & Relationship to child *

Emergency Contact Number *

School/Sixth form/ College *

Media Consent *

Yes

Accessibility Requirements *

Allergies/ Intolerances/ Medical conditions? *

Submit

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