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- Gender*
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- Does your child require glasses to play sport ?*
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- Contact 1 Date of Birth:*
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- Contact 2 Date of Birth:*
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- I will inform the manager of any important changes to my child’s health, medication or needs and also of any changes to our address or phone numbers provided.*
- In the event of illness, having parental responsibility for the above named child, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency medical treatment. *
- I confirm all details above are correct to the best of my knowledge and I am able to give parental consent for my child to travel to and participate in all activities.*
- I give permission for my child’s image to be used, as appropriate, on the Club Website and social media platforms under the guidance of FA directives on child protection.*
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- Today's Date:*
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- Date & Time of Original Consent Form Completion:
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- Leave Date
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- Should be Empty: