Community Sports - Axis Educational Trust

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Basketball

Thursday - 8 pm
East Barnet School Hall

Voleyball

Thursday - 8 pm
East Barnet School Hall

Badminton

Monday - 8 pm

Enfield Drill Hall

Fitness Class -Female only

Thursday - 8 pm
East Barnet School Hall

Community Sports Club Registration

Confidentially:Details on this form will be held securely and will only be shared with coaches or others who need this information in order to meet the specific needs.

Personal Information

Name

Email

Address

Date of Birth

Gender

Male Female Non-binary Another description(please state)

Choose one of the sport activities

Basketball Volleyball Fitness for female Badminton

Are there any activities in which you can not participate?

No Yes - please give details

If yes, please give details

Personal Information-parent / carer (if under 18)

Name

Contact number

Emergency Contact Information

Name of alternative adult to contact in an emergency

Contact number of alternative adult

Relationship to child / young person (if under 18)

Medical Information

- Are there any specific medical conditions requiring medical treatment?

No Yes

Details of medication required ( e.g. pills, inhaler)

- Are there any other medical conditions or disabilities to be aware of?

No Yes

If yes please give details

- Do you/your child have any allergies?

No Yes

If yes please give details

Declaration

I give my consent that if an emergency medical situation arises, the organisation / club may administer first aid and/or other medical treatment that in the opinion of a qualified medical practitioner may be necessary. I also understand that in such circumstances all reasonable steps will be taken.

I give my consent for photo and video

Contact Information

Address:16-17 Grand Arcade, Tally Ho Corner, North Finchley High Road, Industrial House, 2nd floor London, N12 0EH
Phone:0207 607 9330
Email:info@axiseducationaltrust.orgOpens in your application

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