Soccology 3P3

Form to be completed by Parent/Guardian

This form is for parents/guardians to provide permission for their child to take part in Soccology 3P3 trials and match. Providing the opportunity to play against and hopefully be signed by Charlton Athletic FC. This opportunity is being provided as part of the legacy, of former Charlton Athletic FC Pierre Bolangi player, who sadly passed away in 2000. Please note that this process is being managed by volunteers for a non-profit organisation (Soccology), with this being the case, in addition to the standard registration information, we're also requesting information about the person taking part so we have a thorough understanding of the demographics we're reaching.
Player Name:*
Date of Birth:*
Height:*
Age:*
Please note this is for boys who are U15 this season and U16, starting next season. Current Year 10 in school.

If you are a year younger but play up or feel you're good enough too, then you can sign up.
Address:*
Current Team:*
Position(s):*
Prefered Foot:*
Parent's Contact Number:*
Parent's Email:*
How did you hear about this opportunity:*

FriendCoachSoccology social mediaCharlton Athletic FC social mediaKevin George social mediaOther social media platformSearch engineOther
Ethnicity*

White English/Welsh/Scottish/Northern Irish/BritishWhite IrishWhite TravellerWhite any other backgroundWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed/multiple ethnic backgroundIndianPakistaniBangladeshiChineseAny other Asian backgroundBlack AfricanBlack CaribbeanAny other Black/African/Caribbean backgroundArabAny other ethnic group
Who is your child's main carer?*

ParentsCarer
Does your child have any health concerns (physical/mental)? If yes, please provide information in box where it says 'Other'.

YesNoOther
Does your child have Special Educational Needs? If yes, please provide information in box where it says 'Other'.*

YesNoOther
Does your child have any mental health concerns? If yes, please provide information in box where it says 'Other'.*

YesNoOther
Is your child receiving mental health support? If yes, please provide information in box where it says 'Other'.*

YesNoOther
Is an Early Help Assessment and Plan (Common Assessment Framework) open for your child?*

YesNo
Is there other agency involvement with the family within the last 12 months (e.g. police, social care)*

YesNo
Is your child/family seeking asylum or a refugee?*

YesNo
Is English your child's second or additional language*

YesNo
Is your child fostered or adopted? (if yes, please specify in the 'Other' box).*

YesNo
Is your child the subject of a child protection plan?*

YesNo
Are one or more of the child's parents/carers in the armed forces?*

YesNo
Is your child receiving free school meals?*

YesNo
Date:

* Sunday 9th July (THIS SUNDAY)

Location:
* Erith & Belvedere FC, Park View Rd, Welling DA16 1SY

Please bring:
* A bottle of water
* Football boots
* Shin pads
* Wear black t-shirts and shorts.
* Changing rooms and showers available

Time:

12:00pm arrival
By signing and clicking submit, you consent for your child to take part in the football trials, match and permission for Soccology to use their image for publicity purposes, digitally or in print. This includes, when other organisations cover Soccology's work, for example, schools, national newspapers etc. Soccology may contact you to offer future services however, this can be opted out of when received.
Parent Signature*

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Print Parent's Name:*
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Form to be completed by Parent/Guardian