Trampolining Registration Form
Please fill in this form if you would like to confirm your FREE place at Autism Berkshire's Sport England-funded trampolining sessions.

If you would like to make a donation to Autism Berkshire, we would really appreciate your support. The link to donate can be found here: http://www.autismberkshire.org.uk/donate/.

Email address *
Please select the correct option below:
This project is generously funded by Sport England, and we need to ensure everyone can gain access to our activities if they need to. We will therefore allocate you a place for 3 terms (1 year) at a time. You may then be placed back on the waiting list if you wish to continue, or we will help you to find a suitable alternative. If there is not a need for you to move on, we will not ask - it will be purely dependent on the waiting list need. *
Required
I agree that I will attend all sessions, and that if I do not attend regularly, my place will be given to the next person on the waiting list. Each case will be considered on an individual basis if, for example, if you are ill. *
Required
Which session are you registering for? *
Attendee first name: *
Your answer
Attendee last name: *
Your answer
What is your age? *
What is your date of birth? *
MM
/
DD
/
YYYY
Do you have an Autism diagnosis? *
Do you have any additional health needs we should be aware of? Please provide some details.
Your answer
Is there any additional information that would be useful for our coaches to know? For example, do you respond better to visual cues or do you use makaton?
Your answer
Have you attended Autism Berkshire trampolining sessions before? *
Main contact name: *
Your answer
Main contact email address: *
Your answer
Main contact telephone number: *
Your answer
Emergency contact name: *
Your answer
Emergency contact telephone number: *
Your answer
Address: *
Your answer
Postcode: *
Your answer
I agree/acknowledge that: *
Required
Data Protection (please tick all that apply): *
Required
I am happy to be contacted by (please tick all that apply): *
Required
Your confirmation: *
Required
Privacy Notice
We will always store you person data securely. We will use them to communicate with you and to provide any service that you have requested. Your data may also be used for analysis purposes to help us provide the best possible service and for monitoring purposes by our funders. We will only share it if it is required to do so by law.

For details of our Data Protections Policy, please see our website at www.autismberkshire.org.uk.
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