Wildcats Sign Up Form
Sign up form for Bure Park Juniors SSE Wildcats
Email address *
Participant First Name *
Your answer
Participant Last Name *
Your answer
Participant Date of Birth *
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Gender *
Ethnicity *
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Does this Participant Have a Disability? If Yes please pride details? *
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Parent/Carer Name *
Your answer
Parent/Carer Email Address *
Your answer
Mobile/Emergency Contact Number *
Your answer
Do you as Parent/Carer Give Consent for your Child to take part in these activities? *
Does the Young Person Have Any Access Needs? If Yes, Please Provide Details *
Your answer
Does the Young Person Have Any Communication Needs? If Yes, please provide details below. *
Your answer
Consent for Photo’s or Imagery to be used on the club websites or social media? *
Consent Given for The FA To Use The Contact Details Provided, To Contact Regarding Women And Girls’ Football Opportunities? *
Consent Given for SSE To Use the Contact Details Provided, To Contact Regarding Women And Girls’ Football Opportunities? *
Is This Participant New to The Centre? *
A copy of your responses will be emailed to the address that you provided.
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