Booking - soccerkicks

Childs Name

Age

Address

School

Medical Conditions

Centre

Our Lady St Chads, Monday 5pm-6pm 5-8 Years GK Development Our Lady St Chads, Fridays 6pm-7pm 7-15 Years Our Lady st Chads, Friday 5pm-6pm 6-8 Years Our Lady st Chads, Friday 6pm-7pm 9-12 Years Westcroft School , Saturday 10am-11am 4-7 Years Westcroft School, Saturday 11:30am-12:30pm 8-12 Years

Parent/Carers Name

Contact Number

Emergency Contact 1

Emerceny Contact 2

Consent

I give permission for my Child to attend SoccerKicks event and I understand that the organisers and coaches cannot be held responsible for loss or damage to property or personnal injury.

Photography/filming Consent

I give permission for my child to be included in photographs/filming during SoccerKicks events and understand that such videos/ images may be used for advertising for SoccerKicks future events.

Emergency Aid

In the unlikely event of an accident or illness which needs immediate medical attention, I give permission for emergency aid to be administered where necessary by the coach in charge

Emergency Aid

If I cannot be contacted and my child requires Emergency Hospital treatment, I authorise a qualified practioner to provide Emergency treatment.

Terms & Conditions

I will pay in full by the date provided by Soccerkicks • I will pick up my child on time • I will abide by SoccerKicks code of conduct/health & safety rules and accept that i have read and understood those rules• FAILURE to follow these rules could result in you losing your place at our Soccer Development centres • I will sign and agree to the terms and conditions stated above. Each development centre session is £5.00 paid monthly in advance, £20 per month/every 4 weeks. No refunds will be given if your child does not attend any sessions, unless the absence is caused by factors beyond the control of guardian’s and only after prior consultation with SoccerKicks Academy Manager. All Players must wear shin pads.

* Required

Booking Form