Registration - Boys and Girls Clubs Scotland

Player Info

Individual Player/Sponsor/Club*

Name*

First Last

Address*

Street Address Address Line 2 City ZIP / Postal Code

Phone*

Date of Birth

Club

What team are you in?

What age group do you play in

Name*

First Last

Phone (mobile)*

Phone (home/work)

Family Doctor

Phone*

Medical Conditions

Please detail any medical conditions/allergies (e.g. penicillin, hay fever, nuts or food) that you have, that we should be aware of?

Medication

Please provide details of any medication that you take

Injuries

Does you have any past of current injuries that we should be aware of?

Dietary Requirements

Do you have any specific dietary needs e.g. vegetarian, low cholesterol or low fat diet? If so, please give details

We will send important information to this account please make sure it is accessed regularly

Contact Email*

Photography

I give permission for photographs/imagery taken at the event and to be used for future publicity

Consent

I give permission for my child (aforementioned Player) to participate in the forthcoming event