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Chelsea FC Soccer Schools

Soccer Schools Online Booker

ACTIVITY DETAILS (the Activity)

Session: Bridging Forces
Date: Monday, 24 June

PARTICIPANT DETAILS

First Name: *
Last Name: *
Date of Birth: *
Gender: *
Ethnicity:
Please note that by providing ethicity, you consent to the Foundation use of the ethnicity data provided for the purposes and in the manner described in the 'Personal Data' section below.

BOOKER DETAILS

First Name: *
Last Name: *
Country: *
Address:
:
:
:
Telephone:
Email: *

SECOND EMERGENCY CONTACT

Emergency Contact Name:
Emergency Contact Number:

BOOKING CONSENTS

Supervision

The attendee will be supervised by Chelsea Foundation staff while at the Activity. We are committed through trained and competent staff to providing a safe learning environment, however football and the other sports they will try may cause injuries through no negligence of our staff. We feel it is our responsibility to ensure the safety of the attendee by making sure they come well equipped for the activity i.e. correct footwear, appropriate clothing, medication (if applicable).

 I consent to the attendee being supervised by Foundation staff while they are at the Activity

Use of Images

Photos and videos of the attendee may be taken at the Activity (the Images).

The Foundation would like to use the Images to promote the work of the Foundation and grant Chelsea Football Club the right to do the same. This use may include print advertising, digital advertising and/or inclusion in presentations to partners, funders and other charitable organisation the Foundation works with or wishes to work with.

 Please tick this box if you consent to the use of the Images described above.

Medical attention

If the attendee needs medical attention at any time during the Activity or while they are present at Stamford Bridge, the Foundation or Chelsea Football Club may provide or arrange for the attendee to receive medical treatment and/or to be transported to a medical facility from the Activity:

 I consent to the attendee receiving medical treatment and/or transportation to a medical facility from the Foundation or Chelsea Football Club.

Personal data

The Foundation will use your personal data and the personal data of the attendee for the purposes of: (a) operating the Activity; (b) looking after the attendee during the Activity; (c) tracking the attendee's progress; (d) developing case studies and testimonials where you have given your consent to do so below; and (d) communication with the attendee's school about the attendee and the Activity and the other purposes described on this form. The Foundation may share ythe attendee's personal data with the attendee's school and with the Premier League Charitable Fund.

By completing this form, you acknowledge our use of the attendee's personal data in the manner described above and in accordance with our privacy policy.

Where we ask for your consent on this form for use of the attendee's personal data (including images) you can withdraw that consent at any time by contacting dataprotection@chelseafc.com.

CASE STUDIES

The Foundation would like to submit a case study of the attendee's participation in the Activity to the Premier League Charitable Fund (the PLCF). The case study will involve speaking to the attendee about their participation in the Activity and may include video and images. The case study will be shared with the PLCF and both the PLCF and the Foundation will retain copies of the personal data used in the case study. The Foundation and the PLCF will cease use of photos, images and filming within three years after the date of this form.

If you would be happy for the attendee to participate in a case study but would prefer that they do so anonymously, please let us know.

 Please tick the box if you consent to the attendee participating in a case study and to their personal data being shared with the PLCF as described above.

OTHER INFORMATION

Please use this section to provide information about any dietary, disability and access needs or medical needs of the attendee:

Dietary requirements:
Do you have any additional support needs?:
Do you have any specific access requirements?:
Medical needs:

  I hereby give permission for Chelsea FC Foundation to share the information housed on this registration form with their Monitoring and Evaluation platform 'Views'.

I understand that this information will not be passed on to third parties and will only be used in reporting against the project I am engaged in.