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FANS Card Application Form

Entries marked with * are mandatory.

Is the applicant under 18 years of age? *

Yes
No

Applicant Name *

Address *

Postcode *

Contact Number *

Email *

Date of Birth *

Sport (including discipline) *

Occupation/School *

Name of Club *

National Squad/Team *

Squad Coach's Name

Squad Coach's Contact Number

Squad Coach's Email

Please provide details below of your selection for a Home Country or Great Britain Team within the last 12 months, or of current membership of a Home Country or Great Britain Squad. You should include as much detail as possible. *

You must attach a covering letter from your National Squad Coach or Manager supporting your application here. *

Name of Championship/Event *

Date of Event One *

Name of Championship/Event

Date of Event Two

Name of Championship/Event Three

Date of Event Three

Support Statement Please use the space below to highlight any special circumstances to which the applicant wishes to attention to be drawn. Any information given in this section will be treated as strictly confidential. *

Photo Consent - During your year on the Gedling Elite Athlete Support scheme - Gedling FANS - Gedling Borough Council may wish to take your photograph for promotional purposes. These images may appear in our printed publications, website and in local press. To comply with the General Data Protection Regulations and Data Protection Act 2018, we need your permission before we take any photographs or recordings of the applicant. Please answer the questions below:

May we use the applicant's imagine in printed publications produced by Gedling Borough Council for promotional purposes? *

Yes
No

May we use the applicant's image on our websites? *

Yes
No

May we use the applicant's image to promote the Gedling Elite Athlete Support scheme? *

Yes
No

Mailing List

Tick this box if the applicant would like to be added to our mailing list (including 3rd party emails regarding the membership

For further information on how we use your data please see our privacy policy visit Leisure Privacy Statement. and Community Relations Privacy Statement

To the best of my knowledge, the details in the application are correct. I agree that I will abide by the Terms and Conditions of this award and understand from this form may be used for administration and publicity purposes in accordance with the General Data Protection Regulations and Data Protection Act 2018. *

I accept

New application *

Yes
No

Gedling Leisure Card Number (if known). If you do not have a Gedling Leisure Card you must apply for one, visit your nearest Leisure Centre to apply.