Adult over 16's League 2+1 lower level 5pm-6:30 pm (Inclusion)

 

Online Registration Form

Price category
 *
Attendee Forename
 *
Attendee Surname
 *
Date of birth
   *
Gender
 *
Ethnicity
 *
Do you have a neurodiverse condition or disability
 *
Email
 *
Address 1
 *
Address 2
 *
City
 *
County
Postcode
 *

Medical & Participation Information

Please give details of any other medical concerns (e.g mental health, disability, self-harm). Please specify relevant information including access needs
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?

Parent / Guardian / Carer Details


Please complete the form below for the attendee, making sure to include any dietary/medical requirements or important information.
Forename
 *
Surname
 *
Relationship to attendee
 *
Mobile Number
 *
Email
 *
Address
Address Line 2

Emergency Contact


It is essential that those identified as emergency contact are available during course time.
Emergency Contact 1
Surname
Mobile Number
Emergency Contact 2 (Optional)
Forename
Surname
Mobile Number
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.
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.