Attendee Forename * |
Attendee Middle names
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Attendee Surname * |
Date of birth * |
Group * |
Gender * |
Name of current school
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Address of current school
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Current School Contact Name
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Current School Email Address
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Education History (If over 18 please provide names of the schools you have attended in the past)
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Medical & Participation Information |
Do you have any past or current medical conditions? This includes any condition that requires regular medication or follow-up from your GP, hospital or club doctor (for example, asthma, eczema, hayfever, diabetes, heart conditions, hayfever, epilepsy etc.).
* |
Do you take any regular medication, inhalers or supplements?
* |
Do you have any known ALLERGIES? Either from medications, foods or anything else?
* |
Do you have a neurodiverse condition such as ADHD, Autism, Dyspraxia, and Dyslexia?
* |
If 'Yes' to the last two questions, how can we help support you? (You may share any professional reports, advice or formal plans with us if you feel that it will help us understand how to do our best for you.) If not relevant, please write N/A.
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Are you/have you ever been in the care of the Local Authority?
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Do you have a social worker?
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Is there anyone who is not allowed contact with you or your child?
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Briefly explain your current exercise / training regime. For example, amount of PE lessons, extra-curricular activities, hobbies, any other sports. Please explain the duration of these activities and the level at which you complete them ? including detailing any strength/plyometric/power training if relevant;
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Do you have a 'Child in Need Plan', 'Child Protection Plan' now or in the last 12 months?
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If an emergency medical situation arises, for administration of first aid and/or other medical treatment which in the opinion of a qualified medical practitioner may be necessary and in the comfort that in such circumstances that all reasonable steps are made, can MK Dons act on your behalf?
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Parent / Guardian / Carer DetailsPlease complete the form below for the attendee, making sure to include any dietary/medical requirements or important information. |
Parent/ Guardian - 1 Name * |
Parent/ Guardian - 1 Relationship to attendee * |
Parent/ Guardian - 1 Email * |
Parent/ Guardian - 1 Mobile Number * |
Address 1 * |
Address 2
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City * |
County * |
Postcode * |
Emergency ContactIt is essential that those identified as emergency contact are available during course time.Emergency Contact 1 |
Emergency Contact is the same as on the Parent Guardian Section
* |
Emergency Contact 2 (Optional) |
Emergency -2 Name
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Emergency -2 Relationship to attendee
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Emergency -2 Mobile Number
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Emergency -2 Email
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Promotional code |
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* |
I consent that during the course photography/ videos of the attendee may be taken during the session. These may be then used for the purpose of advertisement and promotion on through website, social media, and print media. |
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* |
MK Dons SET may use your personal data (including, but not limited to, your personal phone number and/or email address) to contact you regarding training and matches and other MK Dons SET information via communication platforms such as Spond/Whats app and email. |