NUSA School - PL Kicks - Football 
Project: PL KICKS
Venue: NUSA School
Type of activity: PL Kicks Sessions
Date: Every Monday Unless Notified
Time: 5pm - 6pm

We will be located on the astro pitch and court 6.

PLEASE BRING: Appropriate clothing (including shin pads), refreshments and appropriate footwear (NO STUDS OR MOULDED BOOTS, astroturf trainers / trainers permitted)

Please note your child must be between 8 and 15 years to receive a free place.

In order to take part in this activity, we need to collect basic details about the participant, including information about their health, any disability and other additional needs. We need this information to provide appropriate care and support to the participant during the activity and take appropriate emergency action if necessary.

A requirement of this funding is that we collect information from participants to understand the impact of our activities. We also use this information to improve our work. Notts County Foundation will collect and use your child’s information to report to their funders, as well for our own monitoring and evaluation. All personal data will be kept confidential and no personal data will be shared.

For further information regarding our data collection, please contact Matt Muir on Matt.Muir@nottscountyfoundation.org.uk


DATA:

The information provided on this form will be held securely and will only be shared with those who need this information in order to keep the participant safe and meet the specific needs of the participant during the activity. Anonymized information relating to age, gender, postcode, disability/additional needs and ethnicity may also be used for reporting purposes.

PHOTOGRAPHS:

In accordance with our Safeguarding Policy we will not permit photographs, video or other images of adults taking part in Club activities to be taken without the consent from themselves or a parent/carer. Occasionally we may take pictures and allow filming/recording for training or promotional purposes. By signing this consent form you agree to permit Notts County Foundation and/or any person authorized on their behalf to take and publish images taken of the adult named and set out below. We will take all steps to ensure that images are used solely for the purposes agreed by you.

We will not use the full name stated below in any accompanying text or photo caption on our website, social media platforms or in any of our printed publications.

This consent is valid for five years from the date that it is signed. You, or your child, can withdraw your consent at any time please contact Matt.Muir@nottscountyfoundation.org.uk . All data held by us will be stored/processed in line with our Privacy Notice.
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What is your child's first name?
What is your child's surname?
What is their date of birth?
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What is their ethnicity?
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What is their gender?
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What is your postcode?
Please give details of any disabilities, additional needs or cultural needs that may affect participation in the activity?
Please give details of all medical conditions e.g. asthma, allergies, illnesses or injuries that might affect participation in the activity?
Please give details of any dietary requirements?
I confirm that the participant is otherwise in good health and is capable of taking part in the activity. I confirm that I have given details of all medical conditions above (parental permission)                              
I give my consent to the participant taking part in the activity specified above (parental permission)
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Please indicate whether you give permission  for pictures of your child to be taken for reporting,  marketing and promotion purposes. This includes social media. I also consent to Notts County Foundation to keep this images on file for an indefinite period.
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Emergency contact 1 name
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Emergency contact 2 name
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