WHEELZ Sign Up Form Location: City AcademyCost: £8 per session Player's name * First Name Last Name Player's age * Player's birthdate * MM DD YYYY Player's school Does the player have health conditions which the coaches need to be aware of? * Does the player have allergies which the coaches need to be aware of? * Emergency contact name * Emergency contact number * Contact email * Photograph consent * Yes, the player can have photographs taken No, the player is not able to have photographs taken First Aid consent * Yes, the player can have first aid treatment given by a qualified first aider at a Hoopstars session No, the player isn't allowed to have first aid treatment at a Hoopstars session We have been awarded funding to support asylum seekers and refugees to participate in basketball. If you would like to receive financial support in the form of a free space for you or your child, please confirm your immigration status below: * Asylum Seeker Refugee No Applicable How did you hear about us? * Please provide specific details about any additional needs, accommodations, or requirements you may have. This could include information about mobility challenges, medical conditions, or any other factors that may impact your participation in wheelchair basketball. This information will help us ensure that you have the best experience possible during our sessions. * Thank you!
