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Level Playing Field South Forum 17th November registration form for fans
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1.
First name
(Required.)
*
2.
Last name
(Required.)
*
3.
Contact e-mail
(Required.)
4.
Contact phone number
5.
Please let us know if you have any access requirements (e.g. interpreter, large print text, subtitles)
6.
Will you be bringing a companion/PA?
Yes
No
7.
If you know the name of your personal assistant (PA), please provide it below.
8.
Which club do you support?
9.
Are you a member of your club's Disabled Supporters Association (DSA)?
Yes
No
10.
Are you a member of any other supporter organisations? (e.g. Supporter's Trust)
Yes
No
11.
Do you or your PA/companion have any dietary requirements, including any allergies? (please list all)
Do not list food you don't like.
12.
Do you require parking?
Yes (accessible parking)
Yes (general parking)
No
13.
If you require parking, please provide your vehicle registration number
14.
You can sign up to Level Playing Field's fan newsletter.
Yes please, sign me up.
No thanks, I'm not interested at this time.