Attendee sign-up

First name *

Last name *

If you are trying to sign up and are under 17 please click on this link to sign up to our Children & Young People project. Thanks!

https://app.upshot.org.uk/signup/847f0d54/

Date of Birth * e.g. 26/05/2001

Contact relationship type You are stating that you are the adult responsible for this young person and give your consent to be registered on Upshot (which includes permission to attend sessions).

Contact first name

Contact last name

Gender *

Address line 1 *

Town/City *

Postcode *

Contact email address * If you do not have an email address, please enter noreply@upshot.org.uk

Mobile phone * Put N/A if you do not own a mobile, and indicate your preferred contact number below

Other telephone number

Type of Participant: *

Emergency Contact - Name: *

Emergency Contact - Relationship to Participant: *

Emergency Contact - Phone Number: *

Please state your mental health condition(s): *

If 'Other' chosen for mental health condition please state:

Please explain any specific requirements you may have:

Do you have a Disability? * If yes please give details below

Disability: If yes please specify below

Do you have any other medical conditions? *

If Yes, which medical conditions?

If 'Other' for Medical condition, please state below:

Are you pregnant ?

If pregnant, date that the baby is due.

1. Has your doctor ever said you have a heart condition? *

2. Do you feel pain in your chest when you do physical activity? *

3. Do you ever lose balance because of dizziness or ever lose consciousness? *

4. In the past month, have you had pain in your chest when NOT doing physical activity? *

5. Do you have bone/joint problems that could be worsened by a change in physical activity? *

I understand that if I answered YES to any of the above ‘Readiness For Exercise’ questions, I must seek medical advice before I attend a Sport in Mind activity. I agree I am taking part at my own risk and will update Sport in Mind if there is any change in my health condition/s.

Activity Declaration *

Activity Declaration - Date: *

How did you hear about our charity? * Please select one option only

If 'Other' chosen please state:

I am happy to participate in research? *

The following sets out categories for monitoring ethnicity. We ask you to respond to this information as it will help us ensure that our policies and practices do not inadvertently discriminate against you because of your ethnicity. Sport in Mind aims to ensure they reach out to a diverse population and include them in sports sessions (or as employees, coaches if applicable). Please choose the ethnicity which best describes you from the drop-down list.

Which of the following best describes you?

Please specify ethnicity if not listed and you wish to do so:

I give permission for the use of photos or other media featuring me. This may include audio, video, or photo images at our sessions to help with Sport in Mind's marketing, funding, or reporting purposes. You can withdraw this consent at any time.

I give permission to receive emails from Sport in Mind via Upshot

Thank you for completing this form. By signing up to take part, I give permission for the information provided in this form to be held in a secure electronic format and used by Sport in Mind only in connection with our sessions.

Sport in Mind will control your personal data in compliance with the Data Protection Act 2018 (incorporating the General Data Protection Regulation). Data will be used to help monitor the success of our programmes and help plan future groups. Your data will not be disclosed to anyone outside of Sport in Mind, except where impersonal statistical data may be derived and used for management analysis and reporting statistics to funding bodies.

CODE OF CONDUCT

Sport in Mind promotes positive sport and physical activity experiences for everyone. The following code of conduct applies to EVERYONE involved in our sessions and events (participants, spectators, parents/carers, support staff, volunteers and coaches). All individuals will:

1. Show respect for everyone at all times
2. Inspire and encourage those around them
3. Avoid using inappropriate language such as telling discriminatory jokes, name calling or make any remarks on grounds of race, gender, sexuality, disability or age.
4. Avoid using any aggressive, threatening or inappropriate behaviour
5. Not possess or consume illegal substances, drugs nor alcohol at the sessions
6. Not access sessions whilst under the influence of alcohol or illicit drugs
7. Avoid the use of physical violence under any circumstances
8. Positively reinforce the development of everyone in a fun, safe and supportive environment

Should anyone act in a way contrary to the above Code of Conduct that person or persons concerned will be asked to leave the session immediately to protect the wellbeing of all others. The matter will then be referred to the Sport in Mind Board of Trustees to ensure that the ethos and objectives of Sport in Mind are maintained.

I accept the organisation's Terms & Conditions and Privacy Policy *

Finally, please confirm you are a real person. *

Sign up with Sport in Mind

Your Details

Emergency Contacts

Medical Information

Readiness for Exercise

Finding Out

Ethnicity Monitoring Form

Permission Fields

Confirmation

Terms & Conditions and Privacy Policy