LiFT CIC Session Consent Form

LiFT CIC

Community Football Participation Consent Form
Rules of Respect:

By completing this form, I agree to abide by these rules:
- No racist, sexist or abusive language or behaviour
- No smoking/vaping on/or around the sessions
- No drinking alcohol or taking drugs on/or around the sessions
- No weapons on/or around the sessions
- No food/drink to be taken on the playing area (water is acceptable)
- Respect other people’s belongings
- Play by the session/event rules
- Play fairly and be gracious in victory and/or defeat
- RESPECT AT ALL TIMES!
Terms & Conditions (Please read carefully)
- I acknowledge that all participants will be responsible for making their own way to and from sessions/events unless informed otherwise
- I authorise the member of staff that has a valid emergency first aid certificate on site to administer emergency medical treatment, including signing a consent form on my behalf if required by medical services
- I acknowledge that members of staff are only responsible for participants whilst they are attending sessions/events. Participants are free to come and go as they please during the sessions/events and staff cannot be held responsible for their welfare once they have left the site
- I acknowledge and accept that the respective servants shall not have any liability in respect of any loss or damage to persons or property whilst attending the applied sessions/events and that members of staff reserve the right to refuse admission
Please complete all details below:
Participants First Name*
Participants Last Name*
Date of Birth*

DayMonthYear
Age*
Gender*
Ethnicity*
Address line 1*
Address line 2
Post Code*
E-mail Address
example@example.com
Participants Contact Number
School/College
Medical Conditions/Allergies
Disabilities
Injuries
Emergency Contact Name 1*
Emergency Contact Number 1*
E-mail Address*
Emergency Contact Name 2
Emergency Contact Number 2
E-mail Address
Which venue will you/your child be attending?:*
At the end of the session my child will be:*
Do you give consent for your child to be given First Aid treatment if required?*
*** Photos/videos may be taken during the sessions by LiFT CIC staff/volunteers and/or partner organisations for publicity and monitoring purposes ***
Do you give permission for the taking and publication of photos/videos by LiFT CIC and/or partner organisations?*
I agree that I will abide by ALL rules of respect and the terms and conditions above.
Signed: (Participant)

Clear
Date

DayMonthYear
Date
Signed: (Parent/Guardian) (Required if under 16 years old)

Clear
Date

DayMonthYear
Date
LiFT CIC will use your information for admin, marketing and customer service purposes only. We DO NOT share your information with partner organisations. Do you give LiFT CIC permission to contact you about any courses, services that you may be interested in?*
As part of our marketing strategy and to keep you informed of any updates or developments of any sessions/services, LiFT CIC have created a WhatsApp group in which information will be shared. Do you give consent to be added to this group?*
You cannot be added if you are under the age of 13
Name of person to be added to the group
Telephone number of person to be added to the group
For session information or questions, please contact: info@liftcic.co.uk
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