Attendee Forename * |
Attendee Surname * |
Date of birth * |
Gender * |
Ethnicity * |
Email * |
Do you have a neurodiverse condition or disability
* |
Address 1 * |
Address 2 * |
City * |
County
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Postcode * |
Medical & Participation Information |
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Please give details of any other medical concerns (e.g mental health, disability, self-harm). Please specify relevant information including access needs
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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. |
Forename * |
Surname * |
Relationship to attendee * |
Mobile Number * |
Email * |
Address |
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Address Line 2
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Emergency ContactIt is essential that those identified as emergency contact are available during course time.Emergency Contact 1 |
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Surname
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Mobile Number
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Emergency Contact 2 (Optional) |
Forename
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Surname
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Mobile Number
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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. |