Chelsea FC Foundation Kicks Registration Form

  • Chelsea FC Foundation Kicks Registration Form

  • Premier League Kicks, funded by the Premier League through the Premier League Charitable Fund, uses the power of football and sport to inspire young people to reach their potential.

    Through our free sports provisions to 8-18 year olds in South West London we aim to:

    • Promote participation in sport in areas of high need
    • Inspire and support young people to progress into positive pathways, building supportive relationships with one another and the authorities
    • Promote integration and champion equality, diversity and inclusion

    By completing this registration form, you confirm that you: consent to us collecting, processing and storing your special category data, that you have provided. Collection of this special category data is for health and safety purposes, as well as reporting on our Charitable impact.

  • Young Person's Information

  • Young Person's Date of Birth*
     - -

  • Medical Information

  • Does the young person consider themselves to have a disability?*
  • Does the young person have any of the following medical conditions?
  • Does the young person carry an Adrenaline Auto-Injector (AAI)?*
  • Is the player undergoing any medical treatment at present?*
  • Does the player take any medication?*
  • Has the young person suffered any broken bones or had any serious injury or surgery in the past 12 months?*

  • Parent / Guardian Contact Details

    Your additional Emergency Contact must but different to your Parent / Guardian Contact details
  • Format: 00000000000.

  • Walking Home Alone Consent

    Refer to section 2 on Terms and Conditions

  • Consent

  • Photos and videos of your child may be taken at the Activity (the Images).The Foundation would like to use the Images to promote the work of the Foundation and grant Chelsea Football Club the right to do the same. This use may include print advertising, digital advertising and/or inclusion in presentations to partners, funders and other charitable organisations the Foundation works with or wishes to work with.*

  • Chelsea FC Foundation may share your / your child’s data collected in this form with the Youth Activity Alliance (YAA), who part fund the Chelsea FC Foundation delivery at Westway. I understand that YAA will become the data controller for this information and will process it in accordance with the UK GDPR, the Data Protection Act 2018, and their privacy policy. I understand that I may withdraw this consent at any time by contacting YAA directly.

  • YAA Data Sharing:*

  • Chelsea FC Foundation may share your / your child’s data collected in this form with Everyone Active, who part fund the Chelsea FC Foundation delivery at Pimlico, Little Venice and Churchill Gardens. I understand that Everyone Active will become the data controller for this information and will process it in accordance with the UK GDPR, the Data Protection Act 2018, and their privacy policy. I understand that I may withdraw this consent at any time by contacting Everyone Active directly.

  • Everyone Active Data Sharing:*

  • Chelsea FC Foundation may share your / your child’s data collected in this form with Wandsworth Borough Council, who part fund the Chelsea FC Foundation delivery at all sessions in Wandsworth. I understand that Wandworth Borough Council will become the data controller for this information and will process it in accordance with the UK GDPR, the Data Protection Act 2018, and their privacy policy. I understand that I may withdraw this consent at any time by contacting Wandsworth Borough Council directly.

  • Wandsworth Borough Council Data Sharing:*

  • All data provided on this form is processed in accordance with the Chelsea FC Privacy Policy

  • Submission Date
     - -
  • Submission Date+11
     - -
  • Should be Empty: