OCTOBER HALF TERM FOOTBALL FUN DAY 2023
Form
Childs name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency contact number 1
Please enter a valid phone number.
Relationship to child
Emergency contact number 2
Please enter a valid phone number.
Relationship to child
Email
example@example.com
Medical conditions and allergies
In the case of an emergency I agree to my child receiving first aid treatment
I give permission for my child to take part in group photos/videos for promotional use on social media
I agree that Teknique sports and soccer coaching are unable to offer refunds if my child is unable to attend
yes
I agree to make payment within 5 days to secure my child's place
Submit
Should be Empty: