G.C.S SURREY RAMS AFTER-SCHOOL BASKETBALL CLUB – 2023 ONLINE REGISTRATION FORM 2023 SPRING GUILDFORD COUNTY AFTER-SCHOOL BASKETBALL CLUB LITERATURE >>> PLEASE CLICK HERE AND READ PDF OF COURSE INFO BEFORE COMPLETING REGISTRATION If you are human, leave this field blank. This 2023 online form is the quickest way to register your son/daughter to the 10 week class. 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 10 WEEKS SEPTEMBER – JANUARY – MARCH 2023 AFTER SCHOOL CLUB IS: 16TH JANUARY – 27TH MARCH 2023 GUILDFORD COUNTY SCHOOL AFTER-SCHOOL SURREY RAMS BASKETBALL CLUB COST *Please note the sessions will cost £45.00 (£5.00 per session) for the 10 weeks (FIRST WEEK IS FREE). *** PARENTS ARE ADVISED THAT THIS IS VERY POPULAR CLUB AND SPACES ARE LIMITED. Please note that is a first come first served offer as there is a limit of 20 students per session. Once club spaces are filled, students will be put on the waiting list for September 2023 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. Payment options. Option 1 (Preferred method): Online Payment - Due before 16th January 2023 to secure your child's spot on the after-school club Option 2: Cash Payment - due 16th January 2023 (Parents or students can hand this to coach after the session Please select payment option: *Option 1) Online PaymentOption 2) Cash paymentSTUDENT DETAILS:Please enter student's first name *Please enter student's last name *Please enter student's address *Apt, suite, etc.CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityZip codePlease enter student's D.O.B(please use the following format i.e - 01/01/2001)EthnicityWhilst it is not compulsory that the following section is completed the footnote at the end of this template explains why it is important.White - BritishWhite - IrishWhite - other Mixed - White & Black CaribbeanMixed - White & AsianMixed - White & Black Africanother mixed backgroundAsian or Asian British - IndianAsian or Asian British - PakistaniAsian or Asian British - Bangladeshiother Asian backgroundBlack or Black British - CaribbeanBlack or Black British - AfricanBlack or Black British - other black backgroundChinese or other ethnic group - ChineseChinese or other ethnic group - other ethnic group not listedother - not listedMedical 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’.YesNoEMERGENCY 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 SmithPlease 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 clubI DO NOT agree to my son/daughter in my care taking part in the activities of the clubSurrey Rams Promo and particapation declarationBy 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 boxPlease 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.Submit
