Cantelowes
Participant's Details
Forename
Surname
Date Of Birth
Address 1
Address2
Town
County
Post Code
Mobile
Email
School/College Name
School/College Address
Demographic
Ethnicity
Please choose a value
Asian/Asian British - Indian
Asian/Asian British - Pakistani
Asian/Asian British - Chinese
Asian/Asian British - Bangladeshi
Asian/Asian British - Other
Asian/Asian British - (Unspecified)
Black/African/Caribbean/Black British - African
Black/African/Caribbean/Black British - Caribbean
Black/African/Caribbean/Black British - Other
Black/African/Caribbean/Black British - (Unspecified)
Mixed/multiple ethnic groups - White and Asian
Mixed/multiple ethnic groups - White and Black African
Mixed/multiple ethnic groups - White and Black Caribbean
Mixed/multiple ethnic groups - Other
Mixed/multiple ethnic groups - (Unspecified)
White - Welsh/English/Scottish/Northern Irish/British
White - Irish
White - Gypsy, Roma or Irish Traveller
White - Eastern European
White - Other
White - (Unspecified)
Other ethnic group - Arab
Other ethnic group - Other
Prefer not to say
Gender
Please choose a value
Female
Male
Prefer not to say
Other
Parent/Legal Guardian/Carer Details
Name
Relationship to Child
Address
Home Phone Number
Mobile Phone Number
Email Address
Photographs, Images and Videos
I, the undersigned, by ticking the box below, grant or deny permission to The Arsenal Football Club PLC and all of its associated companies (the "Club"), to use photographs, images and/or videos of the child named above (the "Imagery"), in all media now existing or invented in the future, on a worldwide basis and in perpetuity. Uses include the display, distribution, publication or other use of the Imagery taken during the Activity. I agree that the Imagery may be (i) used by the Club and its associated companies for any purpose (including but not limited to marketing and/or promotional use) or (ii) provided to a third party for its purposes (including but not limited to marketing and/or promotional use). I understand that my child’s full name, if aged under 16, will not be listed in conjunction with the Imagery unless explicit consent is sought.
Please choose a value
Grant Permission
Deny Permission
Transport
If transport by the Club is NOT required: The Arsenal Football Club PLC (the "Club") requires your consent to allow the child named above to travel to/from the venue of the Activity alone.
Please choose a value
I consent to the child travelling to/from the venue alone
I do not consent to the child travelling to/from the venue alone. I agree that I shall be responsible for arranging supervision of the child when travelling to/from the venue.
If transport by the Club is required: The Arsenal Football Club PLC (the “Club”) requires your consent to allow the Club to transport the child named above during the Activity. Transport includes transportation provided by the Club to and from the Activity (where necessary and appropriate in line with the Club’s transport procedures). I, the undersigned, hereby grant or deny permission to the Club, to transport the child named above.
Please choose a value
Grant Permission
Deny Permission
Supervision
The Arsenal Football Club PLC (the "Club") requires your consent to allow the Club to supervise the child named above during the Activity. Supervision includes being in sight or earshot of a Club employee or worker for the Activity. I, the undersigned, hereby grant or deny permission to the Club, to supervise the child named above.
Please choose a value
Grant Permission
Deny Permission
Emergency Contact Details
In an emergency, if different from the Parent/Legal Guardian/Carer named above, the following person should be contacted:
Name
Relationship to Participants
Address
Home Phone Number
Mobile Phone Number
Email Address
Individual Needs
I, the undersigned, provide the below information in relation to the child named above to assist The Arsenal Football Club PLC with the performance of the Activity, to ensure that the child's individual needs are considered
Dietary & Allergies
Disability & Access Needs
Medication
Religious & Cultural Needs
Any other needs
Medical
I, the undersigned, acknowledge that I fully understand the nature of the Activity and that participation in the Activity may give rise to my harm or injury to the child named above. I confirm that I am physically fit enough to take part in the Activity and that I have declared any relevant medical conditions to The Arsenal Football Club PLC (the "Club").
I agree that the child's participation in the Activity is at their own risk and hereby release the Club, its employees, contractors, agents and all of its associated companies (together, "Arsenal") from all liability, responsibility, costs and damages which arise as a result of of the child's participation in the Activity. For the avoidance of doubt, the foregoing does not affect the child's legal rights in the event of personal injury or death arising as a result of the negligence of Arsenal.
If the child sustain any harm or injury due to my participation in the Activity, Arsenal may, in its sole discretion, offer to provide such medical treatment as it determines necessary or appropriate (the Medical Treatment). I hereby consent to emergency Medical Treatment determined necessary by Arsenal and acknowledge that by allowing any non-emergency Medical Treatment to be performed on the child I will be deemed to have consented to such Medical Treatment. If the child receives any Medical Treatment, emergency or non-emergency, I and the child assume all risk of harm or injury which may result (subject to the immediately preceding paragraph).
Safeguarding
The Club is committed to safeguarding and protecting children and young people, and adults at risk. Please see the Club’s safeguarding policies at https://www.arsenal.com/sites/default/files/documents/Safeguarding_Children_and_Young_1.pdf and https://www.arsenal.com/sites/default/files/documents/Safeguarding_Adults_at_Risk_0.pdf.
Signature
I, the undersigned, consent to The Arsenal Football Club PLC storing and processing the above referenced personal data in accordance with all relevant data protection laws. You may withdraw this permission at any time. For further details, see the privacy policy at www.arsenal.com/privacy-policy or write to the Data Protection Officer, The Arsenal Football Club PLC, 75 Drayton Park, London N5 1BU.
Name
Date
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