AFC Rushden & Diamonds/Moulton College Summer Football Holiday Camp
8th - 11th August 2022

Registration

This form is to be completed by the legal carer of the child ahead of each camp. It must not be completed for applicants from different families and households - Separate registrations forms are required. Legal carers are responsible for informing the Club of any changes as they occur. It is important that you fill in this form as fully as possible. Failure to tell us things could mean that the safety and welfare of your child is compromised. The Club and its representatives cannot be held responsible if information has not been shared.

The costs for each camp is as follows:
Per day: £20
Per complete camp: £67

A discount of 20% per camp is given on subsequent children in the same family group.

Travel

Arrangements will be made to collect and return children to and from specific pickup points. It is your responsibility to arrange safe travel to and from the pickup points If you are ever delayed in collecting your child, please make every effort to contact the Club Contact or the escorting helpers so we can discuss arrangements for your child.

Non-football activities

There may be occassions when your child is involved in planned and structured non-football activities such as a trip to the cinema, bowling or participating in a fund-raising event. The club will have collated appropriate information in preparation for the activity (eg: About the journey, the children's various needs and helper skills), identified any potential risks or dangers, minimised the risks and dangers by careful planning and precautions and made sure we know who is responsible for putting precautions into place (eg: Who will carry first aid kit). This process is called a risk assesment.

Parent/Guardian/Carer details
First Name:

Last Name:

Address:


Town:

County:


Postcode:

Email address:

Contact number:

If one or more children are not living with parents, please clarify the legal status of the children and their current carers:

Select Days:

   8th
   9th
   10th
   11th


I give consent for the children who are detailed below to participate in AFC Rushden & Diamonds events and agree to the conditions outlined above. I accept that it is my responsibility to inform the club directly of any changes to the details recorded on this form.

Signed (please type name in box):


Child 1 details
Full Name:

D.O.B.:

Current medication:

Frequency:


What does the club need to do to keep your child well (eg: administer medication/give snacks/call ambulance):


Outline any specific training required (other than first aid) to care for your child:


Does your child have any access needs? Please give any details
on how we can help them:


Does your child have any communication needs? (eg: hearing impairment/sign language/dsylexia/non-English speaking):


Images
At times the club may wish to take photos or videos of individuals attending the club. We adhere to the FA guidelines to ensurethese are safe and respectful and used soley for the purpose for which they are intended, which is the promotion and celebration of the activities of the club and for training purposes. Please share any additional information directly with the club.

Please select 'No' if this is not acceptable to you
Yes
No

Child 1 consent
I will take part in AFC Rushden & Diamonds' activities and will stick to the Club rules. I will tell the coach or a member of staff if I do not feel well or if I have any worries.

Signed (please type name in box):


Child 2 details
Full Name:

D.O.B.:

Current medication:

Frequency:


What does the club need to do to keep your child well (eg: administer medication/give snacks/call ambulance):


Outline any specific training required (other than first aid) to care for your child:


Does your child have any access needs? Please give any details
on how we can help them:


Does your child have any communication needs? (eg: hearing impairment/sign language/dsylexia/non-English speaking):


Images
At times the club may wish to take photos or videos of individuals attending the club. We adhere to the FA guidelines to ensurethese are safe and respectful and used soley for the purpose for which they are intended, which is the promotion and celebration of the activities of the club and for training purposes. Please share any additional information directly with the club.

Please select 'No' if this is not acceptable to you
Yes
No

Child 2 consent
I will take part in AFC Rushden & Diamonds' activities and will stick to the Club rules. I will tell the coach or a member of staff if I do not feel well or if I have any worries.

Signed (please type name in box):


Child 3 details
Full Name:

D.O.B.:

Current medication:

Frequency:


What does the club need to do to keep your child well (eg: administer medication/give snacks/call ambulance):


Outline any specific training required (other than first aid) to care for your child:


Does your child have any access needs? Please give any details
on how we can help them:


Does your child have any communication needs? (eg: hearing impairment/sign language/dsylexia/non-English speaking):


Images
At times the club may wish to take photos or videos of individuals attending the club. We adhere to the FA guidelines to ensurethese are safe and respectful and used soley for the purpose for which they are intended, which is the promotion and celebration of the activities of the club and for training purposes. Please share any additional information directly with the club.

Please select 'No' if this is not acceptable to you
Yes
No

Child 3 consent
I will take part in AFC Rushden & Diamonds' activities and will stick to the Club rules. I will tell the coach or a member of staff if I do not feel well or if I have any worries.

Signed (please type name in box):


Submit Form

Please double-check your information, especially your contact details before clicking on Submit.