Kick 'n' Mix: Registration Form

Complete this form to register for our Kick 'n' Mix football and activity session.

Bradford City FC Community Foundation, alongside Active Bradford and Premier League Kicks, are delighted to introduce Kick 'n' Mix!

Kick 'n' Mix is a fun, free new football and activity session for girls aged 8-14 and their family members.

Sessions will take place every Monday, starting Monday 15th June. It's completely free to attend, and will consist of a Premier League Kicks football session, followed by a family activity session, and a free meal! Each participant will be allowed to bring up to two guests to each session, and at least one of these guests must be an adult.

Kick 'n' Mix is for girls only, ages 8-14.

Day: Every MONDAY, starting MONDAY 15TH JUNE

Time: 4.30pm - 5.15pm (Football Session), 5.15pm - 6.30pm (Family Activity Session + Meal)

Location: ST COLUMBA’S CATHOLIC PRIMARY SCHOOL | Tong St, Dudley Hill, Bradford BD4 9PY

If you need support in completing this form, please contact:

E: oliver.read@bcfccommunity.co.uk

T: 01274 706850

Participant personal details:

First name

Last name

Participant Medical Conditions

Does the participant have any medical conditions (please select all that apply)

No medical conditions

Asthma

Diabetes

Other

Medical Conditions: If 'Other' has been selected, please provide additional details:

Does the participant require medication to safely take part? Please select all that apply

No medication

Inhaler

Epipen

Other

Medication: If 'Other' has been selected, please provide additional details:

Participant gender

Participant ethnicity

Does the participant have a disability?

Disability: If 'Other' has been selected, please provide additional details:

Participant dietary requirements/allergies

Please let us know if the participant has any dietary requirements, including allergies:

Participant guest details:

Please let us know the names, ages and dietary requirements for any guests your participant plans to bring to the sessions (please note each participant is permitted to bring two guests, and one of these guests must be an adult).

Please note that if the pariticpant plans to bring other guests to future Kick 'n' Mix sessions, those guests will be required to provide this information upon arrival.

Guest 1 full name:

Guest 1 age:

Guest 1 dietary requirements (including allergies):

Guest 2 full name:

Guest 2 age:

Guest 2 dietary requirements (including allergies):

Main Contact Details:

Main Contact Full Name

Relationship to Participant

Phone

Street Address

Street Address Line 2

City

County

Postcode

Country

Secondary Contact Details

Secondary Contact Full Name

Relationship to Participant

Phone

Please say if you consent for the participant to attend Bradford City FC Community Foundation's Kick 'n' Mix project. If you do consent, you are committing to:

Making sure the participant can travel safely to and from our Kick 'n' Mix provision sites.
Managing the participant's medical needs before, during and after site visits. (Foundation staff will not administer medication to children without formal consent - please email office@bcfccommunity.co.uk for more information or with any questions).
Letting us know should any of your information change (you can email any changes to office@bcfccommunity.co.uk)
Agreeing that the participant can take part in all Kick 'n' Mix projects, both online and in-person.
Making sure that you have read and agreed to the legal terms at the bottom of this form.

Please indicate that you consent for the participant to take part in the Kick 'n' Mix project by ticking 'Yes', entering your name and providing a signature:

I grant consent to attend

I grant media consent

Full name of person granting consent

Your Signature

تم تحديد وضع الرسم. يتطلب الرسم استخدام الماوس أو لوحة اللمس. لإمكانية الوصول إلى لوحة المفاتيح، حدد كتابة أو تحميل.

Legal Terms and Conditions

Bradford City FC Community Foundation excludes any and all liability other than those which cannot be excluded by law.

Media

Sometimes, we and the partners we work with, take photos, film video and record the voice of your child. We call this media consent. We use this consent for marketing, publicity and TV broadcast purposes. When we do this we own all rights to the consent and will use it and share with external media. We will only show your child in a positive way. We will share media consent with Active Bradford and the Premier League Foundation. Find out more about how we use media consent: https://www.bradfordcitycf.org.uk/privacy-policy

Safeguarding

We believe that it is unacceptable for a child, or an adult at risk to experience any kind of abuse. We are responsible for the safety and welfare of your child when they visit our projects. We won't publish information about a child who is subject to family, care or legal proceedings. Find out how we keep your child or adult at risk safe at our projects:

Data Protection Notice

We use the information you have written on this form to safely run our projects. We also use personal details to take registers and improve the quality of our projects. We often gather statistics to show how our work makes a difference to children. We are also required to share personal information with our funding partners. Find our about how we store and process statistics and data: https://www.bradfordcitycf.org.uk/privacy-policy.

Bradford City FC Community Foundation is a registered data controller with the Information Commissioners Office, reference no: Z2849212.