Participant's first name * |
Participant's surname * |
Participant's date of birth * |
Participant's gender * |
Participant's ethnicity * |
Participant's medical information or disability * |
Parent/guardian's details |
Parent/guardian's first name * |
Parent/guardian's surname * |
Contact email address * |
Repeat email * |
Address line 1 * |
Address line 2
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City/town
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County * |
Postcode * |
Country * |
Emergency contact details
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Emergency contact name and number 1 * |
Emergency contact name and number 2 * |
Is the young person currently in school or college?
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Which College/school does the participant attend?
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What PL Kicks team will your young person attend most regularly? * |
Photo consent |
Do you give consent for the participant to be photographed at the event/session to be used for future promotional materials including external providers eg, St Johns Ambulance * |
We'd love to send you the latest information and exclusive offers about The Albion Foundation and West Bromwich Albion Football Club by email, post and SMS. We'll always treat your personal details with the utmost care and will never sell or share them to other companies for marketing purposes Please let us know if you would like us to contact you by selecting the option below |
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