Huntingdonshire District Council
 
St. Ives Rangers Disability FC - Booking Form
First Name:
Surname:
Date of Birth:
Gender
 Male Female
Address:
Post Code:
Telephone Number(Daytime):
Email:
How would you describe your child’s disability?
 Learning difficulties
Physical impairment
Visual impairment
Hearing impairment
Multiple impairment
Other (please specify)
Team
 Juniors (8-16) Adults (16+)
How would you describe your ethnic origin?
  White   Mixed   Chinese
White – British White + Black Caribbean Chinese
Irish White + Black African    
Other white White + Asian    
    Other mixed    
  Asian/Asian British   Black/Black British   Other
Indian Caribbean Other
Pakistan African Refused
Bangladesh Other Black    
Other Asian        
If you have any questions regarding the St. Ives Rangers Disability FC, please contact David Reeve on 01480 387098 or e-mail david.reeve@huntsdc.gov.uk

If you think a friend would like to use this application, please use our 'send to a friend' form

All personal details are held in accordance with the Council’s Data Protection Policy - Privacy Disclaimer




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