BiG Free Females Only Coaching Registration Form

Name

First Name

Last Name

Email address (if 18 years old and older)

Please do not provide email address if under 18 years old

Date of birth

YYYY

Are you under 18 years old?

If under 18, name of parent / carer

First Name

Last Name

if under 18, please provide parent / carer email adress

If under 18, please provide contact number of parent / carer

Mobile number (if under 18, this has to be a parents' or carers')

Please state your ethnicity

Full postal address

Do you have any disabilities?

If yes, please provide accurate information. Please also detail any information that BiG needs to be aware of to make your experience engaging in this programme the best it can be

Are you in either education, employment or training?

If not, what do you do during the day to occupy your time?

Are you known to CAMHS?

We are trying to attract those who are more in need of support to the programme so if you are, this would definitely not exclude you from this programme

Are you known to Youth Offending Service (YOS)?

We are trying to attract those who are more in need of support to the programme so if you are, this would definitely not exclude you from this programme

You will need to agree to comply with all the terms in our risk assessment. Do you agree to agree to the terms once read?:

BiG C.I.C will be recording all of the Programme sessions for training and marketing purposes. We will use recordings to edit and produce marketing films and material and create still shot images, and will post on the BiG C.I.C. website, other social media platforms, and publish in promotion / training material. Please select all the following options where you consent to appear in video clips and still shots for this purpose:

If you are under 18, we will need consent from a parent / carer

Website

Instagram

Twitter

Facebook

Youtube

Promotion material

Training material

All the above

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