* |
Participants Gender * |
Which trial date would you like to attend? * |
Participants First Name * |
Participants Last Name * |
Participants Date Of Birth * |
Participants Age * |
Participants Ethnicity * |
Parent/Guardian First Name * |
Parent/Guardian Last Name * |
Address * |
Postcode * |
Parent/Guardian Contact Number * |
Parent/Guardian Email Address * |
Participant Email Address * |
Do you have any medical conditions? * |
Do you have a disability? * |
Have you lived in the UK or Europe for the last three years? * |
If no, please state where
|
Do you have an Education, Health and Care plan? * |
Have you ever been in foster care, care of the Local Authority or supported by the Leaving Care Team? * |
Are you a Young Carer? * |
What School do you attend? * |
What School year group are you in? * |
Are you predicted to achieve 5 or more GCSEs A*- C (inc. Maths and English)? * |
What examination / assessments are you taking and what are your predicted grades? (Please list all subjects with predicted grades alongside) * |
What position do you play? * |
Tell us about your previous playing experience * |
* |
* |
|
|
Please select the 'Full consent' option if you consent to BFCitC capturing photos/videos of you/your child while you are participating in BFCitC events/activities. You accept that the subsequent use of photos/videos maybe utilised in numerous media platforms, including but not limited to print and digital media used by BFCitC and/or agents authorised by BFCitC. |
Consent for photos and videos
* |
Your information will not be shared with any third parties and you can unsubscribe anytime from our database by sending your request via email to community@burnleyfc.com. |
BFCitC are committed through trained competent staff, to provide a safe and secure learning environment. Whilst in our care all participants will be fully supervised, however, football / sport is a contact sport and injuries occur through no negligence of our staff or BFCitC. BFCitC takes no responsibility for any injury or worse of any individuals participating in any of our activities. BFCitC are committed to safeguarding children, young people and vulnerable adults and all BFCitC staff hold an enhanced criminal records check (DBS) and appropriate first aid and safeguarding qualifications. The participants or parent/guardian will ensure any participants arrives for BFCitC activities with the correct equipment and appropriate clothing to take part in the activity. |
* |
I agree to Burnley FC in the Community and/or a 3rd party present to administer first aid. * |
* |
* |