test | Tyrone Mings Academy

Child's Name *

Child's Date of birth *

Current Age *

Gender *

Male
Female
Prefer not to say

I would like to train at *

School Year (current) *

FAN Number (if known)

Parent/Guardian Name *

Parent/Guardian Contact Number *

Parent/Guardian Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Emergency Contact Details *

Same as above
Different

Medical Conditions/Allergies *

If any child attending has a medical condition or any allergies that we should be aware of, please detail them here.

Photography Permission *

I give my permission
I do not give permission

I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group’s aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications.

First Aid Permission *

I give my permission
I do not give permission

I grant full rights for you to carry out first aid on my son/daughter whenever necessary.