Big Bear GRRRRLZ

Big Bear GRRRLZ Football Coaching Form
You will need to fill out one form per child. If you wish to continue with weekly session for coaching please tick the box indicated and we will send a additional form via email.
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

DayMonthYear
Gender*
Areas I wish to improve in:
My child will attend.*

Cornwallis Academy Friday Evening session (19:00 to 20:00)
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

Town

Postal Code
E-mail*
Mobile Number*
MEDICAL INFORMATION
Doctors Surgery

Name
Phone Number

Area CodePhone Number
Medical Concerns
I would like my child to continue with future sessions*

YesNoTo be confirmed
We will from time to time take photos and share on our website and social media platforms.
By submitting this form you agree to:
I give permission for me/my child's photograph to be used within printed marketing materials.

I give permission for me/my child's photograph to be used on the club’s website.

I give permission for me/my child's photograph to be used on the club’s social media pages.

I give permission for drone footage of me/my child to be used on the club’s website.

I give permission for drone footage of me/my child to be used on the club’s social media pages.

I confirm that I have read, or been made aware of, how these images or videos will be stored within the organisation.
Should your child wish to continue attending after the first session, the fee for the remainder of the month will payable in full at that time.

Thereafter, the monthly fee will be £28, payable at the start of each month.

Account details are as follows:

Name on Account: L Wenham
Sort Code: 04-00-03
Account Number: 99665001
Reference: Child's name BB GRRRLZ session
By submitting the form, I, as the parent/guardian of the registrant agree to the above. I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may given under whatever conditions are necessary to preserve the life, limb, or well-being of registrant.

By submitting the form, I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the BBFC, its affiliated organisation and sponsors. Recognising the possibility of physical injury associated with football and in consideration for the BBFC, accepting the registrant for its football programs and activities (the "Programs"). I hereby release, discharge and/or otherwise indemnify the BBFC, its affiliated organisations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilised for the Programs, against any claimby or on behalf of the registrant as a result of the registrant's participation in the programs and/or being transported to or from the same, which transportation I hereby authorise.
Should be Empty:

Big Bear GRRRLZ Football Coaching Form

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION:

MEDICAL INFORMATION