Suffolk Police League Referral Form

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Please complete this form to refer / register player into the league.

Name of player : *

Players Date of Birth : *

YYYY

Gender : *

Male

Female

Other, please state

Parent / Guardian Name : *

Parent / Guardian Email : *

Parent / Guardian Date of Birth : (so we can register player on the FA player registration system)

Address of player : *

Parent / Guardian Phone number : *

2nd Next Of Kin Name : *

2nd Next of Kin Phone Number : *

School or Educational provider : *

Referred by Name : *

Referred by Email : *

Referred by Contact Number : *

Referred by (Organisation) : *

Brief overview of player, including any history we should be aware of : *

Any Medical details or Allergies we should be aware of? *

Any known risk we should be aware of? *

Please confirm if consent is given for photos to be taken and used appropriately through our website and social media channels. *

Yes

Required

Please state if English isn't the first language of player : *

As part of the league there will be opportunities for participants to gain qualifications/experience in different areas from Coaching, Refereeing, Leadership and many others. What would the participant be interested in doing away from the pitch to either gain experience or a qualification in? Any ideas to assist us in off-field opportunities would be great for us to provide these to our participants. *

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