A London Sport for Social Change Charity
SIGN UP FORMRM_Stats First Name *Last Name *Date of Birth *Gender *Select an optionMaleFemaleTransgender Email *Mobile Number *Address * Street Address City State Zip Code Country Name of School *Year in School *Select an optionYear 4: ages 7-8Year 5: ages 9-10Year 6: ages 10-11Year 7: ages 11-12Year 8: ages 12-13Year 9: ages 13-14Year 10: ages 14-15Year 11: ages 15-16Year 12: ages 16-17Year 13: ages 17-18Home School / Employment *Select an optionHome SchoolingCollegeUniversityPart Time WorkFull Time Work Emergency Contact 1 *Relation *Title *Select an optionDameDrLordLadyMissMrMrsMsMxProfessorSirFirst Name *Last Name *Mobile Number *Email * Emergency Contact 2 *Relation *Title *Select an optionDameDrLordLadyMissMrMrsMsMxProfessorSirFirst Name *Last Name *Mobile Number *Email * Do you have a disability? *Select an optionYesNoIf Yes, Please StateHave got a medical condition? *Select an optionYesNoIf Yes, Please StateSeverity of Medical Condition *Select an option12345678910Please select an option between 1 and 10: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 State the severity of your medical condition so we can know how to adequately respond: Key: 1 to 4 = low 5 to 10 = high / requires immediate assistanceDo you carry medication? *Select an optionYesNoIf Yes, Please State Equal Opportunity Data *I AcceptEQUAL OPPORTUNITIES DATA: The Academy has a policy of equal opportunities and anti-racism, aimed at treating everybody fairly irrespective of race, colour or national origin. Please pick the relevant box below to indicate the group to which you belong. Information will be treated in the strictest confidence and used only for statistical monitoring.Ethnicity *Select an optionWhite BritishWhite IrishWhite OtherBlack BritishBlack CaribbeanBlack AfricanBlack OtherMixed White and Black CaribbeanMixed White and Black AfricanMixed White and AsianMixed OtherAsian BritishAsian IndiaAsian PakistaniAsian BangladeshiAsian OtherChineseOther Ethnic GroupEQUAL OPPORTUNITIES DATA: The Academy has a policy of equal opportunities and anti-racism, aimed at treating everybody fairly irrespective of race, colour or national origin. Please pick the relevant box below to indicate the group to which you belong. Information will be treated in the strictest confidence and used only for statistical monitoring.Parent Volunteers *I AcceptPARENT VOLUNTEERS: From time to time parents volunteer their time to assist with events, competitions and administration support. If you would like to volunteer with us please go to our registration form for volunteers. Parents who volunteer their time and skills would be mentioned in our monthly newsletters as a thank you for supporting Track Academy. Quarterly Payments *Yes, I agree.All payments are made in advance on a quarterly basis. Please log into your account on our website to ensure your payment details are up to date. Billing Periods: Q1: January-March - Payment Due on 1st Jan Q2: April-June - Payment Due on 1st Jan Q3: July-September - Payment Due on 1st July Q4: October-December - Payment Due on 1st OctRegistration Fee * Multi Skill Sessions - Once a Week - Quarterly Fee (£ 25) Multi Skill Sessions - Twice a Week - Quarterly Fee (£ 45) Track & Field Sessions - Once a Week - Quarterly Fee (£ 30) Track & Field Sessions - Three Times a Week - Quarterly Fee (£ 50) Agree to Refund Policy *Yes, I agree.By signing up, submitting this form and making a payment, the entrant is indicating his/her agreement to be bound by our non-refundable and cancellation policy. This policy defines how to handle cancellations. Please note, if cancelled, modified or in case of no-show, the total price of the reservation will be charged.Agree to Terms *Yes, I agree.By ticking this box you agree to our terms and conditions. PHOTOGRAPY I understand that photographs in which my child / children or I feature, or written words about, them or me, may be posted on websites, in the press or used in other ways with reference to participation in Track Academy activities, unless I have given prior notification in writing to Track Academy. MENTORING AND EDUCATION Track Academy are an Educational, Mentoring and Sport programme, and therefore reserves the right to manage and action necessary steps to ensure you - the student athlete, receives all educational and mentoring support necessary to ensure their continued participation at Track Academy. This includes, but not limited, to receiving school reports, attending revision classes, inquiring about the athlete’s general wellbeing and arranging suitable mentors where appropriate. We agree to comply with all codes of conduct, policies and procedures of Track Academy. All personal information will be held for Academy purposes only. COMMUNICATION Please be aware for health and safety Track Academy communicate in English only. PARENT VOLUNTEERS From time to time parents volunteer their time to assist with events, competitions and administration support. If you would like to volunteer with us please go to our registration form for volunteers. Parents who volunteer their time and skills would be mentioned in our monthly newsletters as a thank you for supporting Track Academy.