Personal details of participant

FORENAME(S):

SCHOOL:

SURNAME:

AGE: GENDER:DATE OF BIRTH:

Terms and ConditionsThe Foundation explicitly excludes any and all liability other than that which cannot be excluded by law.

Manchester United Data Protection NoticeManchester United Foundation uses the information provided in this form to (amongst other things) ensure that it has the necessary consent of each participant and their contact details and to administer and evaluate the relevant course the participant is taking part in. For further details please see the Manchester United Foundation privacy policy available at www.mufoundation.org. Manchester United Foundation is registered as a Data Controller with the Information Commissioners Office, reference Z152354.

SIGNED (parent/guardian or participant if 18 or over) ..........................................................................................................................

PRINT NAME: ......................................................................................................................... DATE:....................................................

By signing below, I confirm that the person referred to in this form as the participant can take part in the activities arranged by Manchester United Foundation. I have read and agree to the Terms and Conditions and the Data Protection Notice.

DISABILITY:None Yes (If Yes please specify)

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MEDICAL CONDITIONS: None Yes (If Yes please specify)

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Manchester United Foundation Consent FormPROJECT:For office use only

SEASON:

Contact details of parent/guardian (or participant if 18 or over)

ADDRESS:

POSTCODE:

EMERGENCY CONTACT 1NAME: CONTACT NUMBER:

EMERGENCY CONTACT 2 NAME: CONTACT NUMBER:

EMAIL:

RELATIONSHIP TO PARTICIPANT:

NAME:

Image PermissionOccasionally we may take pictures and allow filming for publicity purposes. By signing this form you agree to permit Manchester United Foundation, any companies which are part of the Group and/or any person authorised by a company which is part of the Group to take and publish images of you (if over 18) or your child (if parent/guardian). We own all rights in such images and footage and we are entitled to use them (and allow others to use them) for any purpose provided that such use does not harm the reputation of the relevant individual whose image is used.

Consent is also given for yourself or those under 18 to be interviewed and their comments to be broadcast or used in promotional materials. All such materials may be shared within the Group and/or with our partners and will be held and used in accordance with Manchester United Foundation Privacy Policy - http://www.mufoundation.org/PrivacyPolicy. As part of our safeguarding policy we may not be able to publish information of children who are subject to family, care or legal proceedings.

Image Consent Opt Out Please tick the boxes below if you DO NOT give permission for:

The taking and/publication of images of myself (if over 18) or my child (if parent/guardian) as set out above.

For myself (if over 18) or my child (if parent/guardian) to be interviewed and comments to be broadcast or used in promotional material as set out above.

SCHOOL YEAR: