Inclusion Participant Information

Session details

Participant details

Participant Name(Required)
MM slash DD slash YYYY
Address(Required)

Photo Consent

Official photographs and video of Derby County Community Trust events may be taken and publicised at events. They may be used in a variety of ways by Derby County Community Trust or Derby County Football Club, including those below: • Presentations: DCCT/DCFC internal and external presentations • Websites: www.derbycountycommunitytrust.com, www.dcfc.co.uk • Social media: DCCT/DCFC social media pages [X, Instagram, Facebook, LinkedIn, TikTok] • Publications: DCCT/DCFC leaflets, posters, newsletters, reports and other marketing materials • Applications: DCCT/DCFC awards applications and funding bids • Print and online media: National, regional and local: papers, magazines, news sites, websites, social media • Television and radio: National and regional television; national, regional and local radio • Photography archives: Images/ videos may be kept permanently as an archive of DCCT. Content may be shared beyond these channels with other associated partners. By signing below, you confirm that you are the legal guardian of the participant or over the age of 18 years old and therefore can give permission on behalf of your child or for yourself to be photographed/videoed for the uses outlined above.
I confirm or deny that I give permission the participant (named above) to be photographed/videoed for the uses outlined above.(Required)

Next of Kin Details

Full Name(Required)

First Aid Consent

If named participant is injured I acknowledge the right of Derby County Community Trust staff to administer first aid within the parameters to which they are qualified.
First aid consent(Required)

Data protection statement

Derby County Community Trust may collect information in relation to the participant and parents/guardians to enable them to effectively administer sessions. Such information may be used in accordance with the provisions of GDPR and the Data Protection Act 2018. All data passed to funding parties will be anonymised.
Data statement(Required)

Transport

Parents/Guardians will hold full responsibility to ensure participants to and from our sessions safely.(Required)
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