BURPHAM PRIMARY – SURREY RAMS AFTER SCHOOL BASKETBALL CLUB ONLINE REGISTRATION

Burpham Primary - After School Surrey Rams Basketball Club Registration/Payment Form

Dear Parents Welcome to the online Burpham Primary 2022-23 After-School Surrey Rams Basketball Club Registration/Payment Form.

All forms will be sent to the Surrey Rams online Registration database.

If parents have any questions please feel free to email the Surrey Rams Admin team: admin@surreyrams.net

PLEASE NOTE THE DATES FOR THE 7WEEKS AFTER SCHOOL CLUB IS: 7TH SEPTEMBER- 19TH OCTOBER 2022

THE RAMS AFTER-SCHOOL BASKETBALL CLUB WILL BE HELD ON THE M.U.G.A (Multi Use Games Area).

BURPHAM PRIMARY AFTER-SCHOOL SURREY RAMS BASKETBALL CLUB COST

*Please note the sessions will cost £38.50 (£5.50 Per session) for the 7 weeks

ADDITIONALLY, PLEASE NOTE THAT ONCE THE CLUB HAS STARTED, UNFORTUNATELY NEW STUDENTS CANNOT JOIN AFTER THE FIRST SESSION HAS COMMENCED.

Please note that is a first come first served offer as there is a limit of 15 students per session. Once club spaces are filled, students will be put on the waiting list for the Spring term course. If you are interested, WE ADVISE FILLING COMPLETING THE ONLINE FORM AND MAKING ONLINE PAYMENT ASAP AS THIS WILL SECURE YOUR CHILD'S PLACE ON THE COURSE. (as many parents know from past courses, the Rams after-school basketball course has always been filled to capacity).

Payment options.
Option 1 (Preferred method) Payment due before 1ST SEPTEMBER 2022, unfortunately due to the current Covid-19 pandemic, we are currently not able to take cash payment): Online Payment -
Account details:
Account name: Surrey Rams
Account number: 13236714
Sortcode: 20-21-78
Reference:ChildName_BurphramPrimary

Option 2: Card payment - Payment due on 1ST SEPTEMBER 2022 (Parents are able to pay using our club connect card machine. Unfortunately due to the Covid-19 pandemic, we are currently not able to take cash payment).

Please select your child's year group: *

Use the drop down menu to select age group.

Please select payment option: *

Please indicate if your child will: be collected (please state who), going to external club (please state external club) or going home on their own *

STUDENT DETAILS:

Please enter student's first name *

Please enter student's last name *

Please enter student's address *

Apt, suite, etc.

Country

City

Zip code

Please enter student's D.O.B

(please use the following format i.e - 01/01/2001)

Ethnicity

Whilst it is not compulsory that the following section is completed the footnote at the end of this template explains why it is important.

Medical information *

Please detail below any important medical information that our coaches/ Junior Coordinator should be aware of (e.g. epilepsy, asthma, diabetes etc.)

Does the student consider himself/herself to have a disability? *

The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial long-term adverse effect on his or her ability to carry out normal day-to-day activities’.

Yes

EMERGENCY CONTACT DETAILS:

Please enter parent/gaurdian mobile number *

Please enter parent/gaurdians home telephone number. *

Instructions

* Neither the mobile number nor the email should be that of the student– this could make children vulnerable and is considered poor practice. For a child/young person under the age of 16, the details should be those of the parent/carer.

Emergency Contact details - Please enter full name.

To be completed by the parent/carer Please enter the information below to indicate the person(s) who should be contacted in event of an incident/accident.

Please enter emergency contact number *

Please enter student's parent/gaurdian full name *

for example: John Smith

Please email parent/gaurdian email address *

Please select which statement is applicable to parent's/career declaration *

I agree to my son/daughter in my care taking part in the activities of the club

I DO NOT agree to my son/daughter in my care taking part in the activities of the club

Surrey Rams Promo and particapation declaration

By submitting this completed form, I agree to my son/daughter/child in my care taking part in the activities of the Surrey Rams Basketball After-School Clubs. Additionally by completing this form, I agree to adhere to the code of conduct for parents/carers and my child shall adhere to the code of conduct for Surrey Rams Basketball After-School Club. I understand that I will be kept informed of these activities – for example timing and transport details. I understand in the event of injury or illness all reasonable steps will be taken to contact me, and to deal with that injury/illness appropriately. To comply with the Data Protection Act 1998, we need your permission before taking any images of your child for future advertising and promotion purposes. If you do not wish your child’s photograph to taken or used in any promotional material please tick this box

Please select one of the following regarding promo declaration *

I DO give consent for my child's picture/video to be taken and used for Surrey Rams promotional purposes on social media sites, flyers, ect.

I DO NOT give consent for my child's picture/video to be taken and used for Surrey Rams promotional purposes on social media, flyers, ect.