Game of II Halves

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* 1. Name

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* 2. Email

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* 3. Are you male or female?

Male

Female

Prefer not to say

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* 4. Date of birth?

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* 5. Which one of the following best describes your ethnic group or background?

White

Mixed

Asian

Asian British

Black

Black British

Other (please specify)

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* 6. What type of organisation are you from?

Workplace

Grassroots team

Other (please specify)

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* 7. Why do you want to be a Game of II Halves Ambassador?

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* 8. Do you or any of your friends / family have any lived experience?

Yes

No

Prefer not to say

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* 9. Would you like a Game of II Halves hoodie, if so choose option below?

Red Medium

Red Large

Red XL

Red XXL

Navy Medium

Navy Large

Navy XL

Navy XXL