Youth Football Performance Registration - Gerald Fitness Client Portal

Youth Football Performance | Player Registration & Parental Consent

Contact

Section 1 — Player Information

Please provide your child's details below. This form must be completed by a parent or legal guardian before the player attends their initial Youth Football Performance Assessment with Gerald Latifi.

Player's First Name

Player's Last Name

Player's Date of Birth

Player's School Year

Current Football Club / Academy

Primary Playing Position

Secondary Playing Position

Section 2 — Parent / Legal Guardian Information

Please provide the details of the parent or legal guardian responsible for the player's registration. We will use these details to communicate about coaching sessions, assessments and important safeguarding matters.

Parent / Guardian First Name

Parent / Guardian Last Name

Relationship to Player

Parent / Guardian Email Address

Parent / Guardian Contact Number

Parental Responsibility Declaration

I confirm that I have parental responsibility for the player, or appropriate legal authority to consent to their participation in football performance coaching and assessment activities with Gerald Fitness.

Section 3 — Football Background & Performance Goals

Tell us a little about your child's football experience, current training routine and performance goals. This information will help Gerald understand their sporting background and prepare an age-appropriate, personalised football performance assessment.

How long has the player been playing football?

How many football team training sessions does the player attend per week?

How many football matches does the player usually play per week?

Does the player participate in any other sports or additional training?

What are the player's main football performance goals?

Acceleration (quicker first steps)

Sprint Speed (running faster)

Agility & Change of Direction

Coordination & Movement Technique

Strength & Power

Balance & Body Control

Stamina & Repeat Sprint Fitness

Confidence in Physical Performance

General Athletic Development

Section 4 — Health & Medical Screening

Your child's health and safety are our priority. Please answer the following questions accurately to help Gerald identify any health considerations, injuries or exercise restrictions before their initial football performance assessment.

Some answers may require further discussion or medical advice before participation. All health information will be handled confidentially and in accordance with our Privacy Policy.

Does the player have any diagnosed medical condition or ongoing health issue?

Yes

Not sure

Please provide details of the player's medical condition or health concern.

Does the player currently have an injury, pain or physical limitation, or a previous injury that may affect training?

Yes

Not sure

Please provide details of the player's injury, pain or physical limitation.

Does the player have any known allergies or a history of severe allergic reactions?

Yes

Not sure

Please provide details of the player's allergies or allergic reactions.

Has the player ever experienced unexplained fainting, chest pain, unusual breathlessness or an irregular heartbeat during physical activity?

Yes

Not sure

Please provide details of the symptoms or concerns.

Does the player take any medication or use medical equipment relevant to safe exercise or emergency care?

Yes

Not sure

Please provide details of any relevant medication or medical equipment.

Has a healthcare professional advised the player to avoid, limit or modify physical activity, or is there any other reason they may not be able to exercise safely?

Yes

Not sure

Please provide details of any medical advice or exercise restrictions.

Section 5 — Emergency Contacts, Safeguarding & Parental Consent

The safety and wellbeing of every young player are our priority. Please provide any additional emergency contact information and review the consent arrangements for your child's football performance assessment.

Alternative Emergency Contact — Full Name

Alternative Emergency Contact — Phone Number

Parental Consent — Participation

I give permission for the player named in this form to participate in an age-appropriate football performance assessment and supervised coaching activities with Gerald Latifi. I understand that participation is subject to a review of any relevant health concerns, and that the player may stop an activity at any time.

Health Information — Explicit Consent

I explicitly consent to Gerald Latifi collecting and using the player's relevant health information to review their suitability for football performance training, identify necessary adjustments and prepare appropriate emergency arrangements. I understand that I can withdraw this consent by contacting Gerald Latifi, although this may affect the player's ability to participate safely.

Safeguarding & Communication Acknowledgement

I understand that appointment bookings and administrative communication will be managed through the parent or legal guardian. I agree to confirm appropriate arrival, supervision and collection arrangements with Gerald Latifi before the player's first session and to communicate any safeguarding concerns promptly.

Photography & Video — Marketing Consent

Yes, I give permission for photographs and videos of the player to be used on Gerald Latifi's business website and social media for coaching-related promotional purposes.

No, I do not give permission for the player's photographs or videos to be used for promotional purposes.

Final Parent / Guardian Declaration

I confirm that the information provided in this form is accurate and complete to the best of my knowledge. I agree to inform Gerald Latifi of any changes to the player's health, injuries, medication or other circumstances that may affect their safety before participating in training or assessments.

Parent / Guardian Electronic Signature

Privacy & Data Protection
We collect personal and relevant health information to arrange and support safe, appropriate coaching. Please read our Privacy Policy to understand how your information and the player's information will be used and protected.