Childs Name:

Address:

Address2:

Town:

County:

Postcode:

Date of Birth:

Please give details of any special dietary requirements, including food allergies:

Please give details of any medical condition (e.g. asthma, diabetes, epilepsy, allergies), disability or special educational needs (SEN):

I (the child) hereby agree to abide by the Code of Conduct: I (the child) hereby agree to abide by the Code of Conduct: Yes No

Parent / Guardian Contact Name:

Address:

Address2:

Town:

County:

Postcode:

Contact Number:

Email:

I (the parent) hereby agree to abide by the Code of Conduct: I (the parent) hereby agree to abide by the Code of Conduct: Yes No

Alternative Carer / Emergency Contact Name:

Address:

Address2:

Town:

County:

Postcode:

Contact Number:

Can you help occasionally with any of the following? Can you help occasionally with any of the following? Transport Activities Club Official Other

How often are you in a position to help? How often are you in a position to help? Once a month Once a term Other

Other:

Other:

Please give details of any interests, skills, qualifications or equipment that you are willing to share with the badminton group occasionally:

I give consent for my child to take part in CYB activities, including training, matches and events: I give consent for my child to take part in CYB activities, including training, matches and events: Yes No

I give my consent for photos of my child to be used in badminton publications or for badminton publicity purposes: I give my consent for photos of my child to be used in badminton publications or for badminton publicity purposes: Yes No

I give consent for recording play to aid their development of play: I give consent for recording play to aid their development of play: Yes No