Thank you for arranging your taster session.

As a Children's Activity Association Gold Member we take our safeguarding responsibilities very seriously.

As part of our processes and insurances we must ensure that we have contact details for all parents and guardians of the children we work with. As soon as we work with a child we in effect own the duty of care and our insurance covers the children.

Please could you pop all contact details in the form below. Unfortunately without this information we simply will not be able to conduct any taster sessions.

Team Name

Manager's Name

First Name

Last Name

Manager's Email Address

Manager's Mobile Number

Player 1

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 2

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 3

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 4

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 5

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 6

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 7

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 8

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 9

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 10

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 11

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 12

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 13

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 14

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 15

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

Player 16

Child's Name

First Name

Last Name

Parent/Carer Name

First Name

Last Name

Email Address

Mobile Number

General Information

Any Medical Conditions?

Please provide details of all medical conditions any player within your team has that we need to be aware of.

Signature

Data Protection: Here at Newcastle Futsal we take your privacy seriously and will only use your personal information to provide the products and services you have requested from us. Please click below for our full Privacy Policy. http://www.thefutsalpartnership.com/privacypolicy-newcastle However, from time to time we would like to contact you with details of other events and offers and with information such as newsletters and company updates. We will never pass your details on to any 3rd parties for marketing purposes. We may also, from time to time take photographs for marketing purposes, by ticking the box below you are providing your consent for us to do so. As the team's coach it is your responsibility to ensure you have the correct permission from the children's parents to provide all of the above information.

Signed

I can confirm that I agree with the above terms and conditions and by clicking Submit I am electronically signing to this.

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