Manchester Magic & Mystics Trial Form 2024

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Manchester Magic & Mystics Trial Form 2024

Please note this form is to apply for a trial to be on the Junior National League programme (under 12-19) in the Manchester Magic & Mystics Club 24/25 season. The details in this form will remain confidential. All members appropriate adults must complete this form so we have relevant data to protect both the athlete and the club. Details provided will be used as our main contact details for your athlete.

Please arrive 15 minutes before you trial start time to register.

Email *

Full Name of Athlete *

Date of birth of Athlete *

YYYY

Address of athlete *

Postcode of Athlete *

Gender of athlete *

Female

Male

Prefer not to say

Nationality of athlete *

Country of Birth of athlete *

Ethnicity of athlete *

White - Engligh/Welsh/Scottish/Northern Irish/British

White - Irish

White - Gypsy or Irish Traveller

White - Roma

Any other White Background

Asian or Asian British - Bangladeshi

Asian or Asian British - Chinese

Asian or Asian British - Indian

Asian - Pakistani

Any other Asian Background

Black/African/Caribbean/Black British - African

Black/African/Caribbean/Black British - Caribbean

Any other Black/Caribbean/Black British Background

Mixed/Multiple ethnic groups - White and Asian

Mixed/Multiple ethnic groups - White and Black African

Mixed/Multiple ethinc groups - White and Black Caribbean

Any other Mixed/Multiple ethnic background

Other Ethnic group - Arab

Any other Ethnic group

Prefer not to say

Required

Do you consider your athlete to have a disability? *

Yes

Prefer not to say

If you consider your athlete to have a disability please tick the appropriate box

Hearing Impairment

Visual Impairment

Mental Health Issues

Learning disability/neurodiverse condition

Physical disability

Do not wish to disclose

Parent/Carer Name - this is the contact the club will initially send information to *

Parent/Carer Contact Phone Number - this is the contact the club will initially send information to *

Parent/Carer Email Address - this is the contact the club will initially send information to *

Athlete Place of Education/Work *

Athlete current school year *

Year 4

Year 5

Year 6

Year 7

Year 8

Year 9

Year 10

Year 11

Year 12

Other:

Does your athlete have or have they ever experienced any of the following? Please tick the appropriate box *

Yes

High or low blood pressure

Elevated blood cholesterol

Chest pains brought on by physical exertions

Dizziness or fainting

Asthma or respiratory problems

Allergies

Diabetes

Childhood epilepsy

Any bone, joint or muscular problems with arthritis

Any sustained injuries or illness

Any further comments you wish to make in relation to medical history or injury history?

Athlete's Doctor's Surgery address, including phone number *

Do you agree to your athlete having their photo taken/filming being taken and used/shared on social media, websites linked to the club and wider basketball community? *

Yes

Do you agree to a club official/volunteer administering first aid to your athlete if required? *

Yes

BOYS - Which squad is your athlete trialing for (based on current school years)?

Year 5 & 6 (10am)

Year 7 (11.15am)

Year 8 (12.30pm)

Year 9 (1.45pm)

Year 10 (3pm)

Year 11 & 12 (4.15pm)

Boys

Clear selection

GIRLS - Which squad is your athlete trialing for (based on current school year)?

Year 5 & 6 (10am)

Year 7 & 9 (11.30am)

Year 10-12 (1pm)

Girls

Clear selection

Any other information you feel the club needs to be aware of. This could include any Child Arrangement Orders that impact upon the athlete's collection and pick up or providing additional appropriate adult details.

A copy of your responses will be emailed to the address you provided.

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