Inclusive / Adaptive Session - Player Registration

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26th June 2022 - 11.00am to 1.00pm.

Simply Judo Maghaberry
Maghaberry Community Centre
Maghaberry Rd.
Craigavon
BT67 0JG

Coaches, please use this form to submit the information of any new players that you request to attend the inclusive / adaptive session.

Closing date for applications for this event, is 12.00pm 24th June 2022.

Please complete all details in the form below to allow us to plan and maximise the output of the session for everyone involved.

Thank you for your support

Players First Name *

Players Surname *

Gender of Player

Male

Female

Prefer not to say

Clear selection

Age of Player

Emergency Contact Full Name and Contact Number *

Address and Postcode *

Club of Player *

Please detail any adaptive needs *

Does the player have any allergies or medical conditions we need to be aware of? *

Yes

If you answered yes above, please list what we need to be aware of (or complete with N/A). *

Declaration

I consent to photographs being taken / used for further publicity purposes *

Yes

Electronic Signature in here (type full name) *

Date of submission *

YYYY

Submit

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