WLFA TRIAL REGISTRATION FORM

WOODLANDS LIONS FOOTBALL ACADEMY PTE LTD

3 GAMBAS CRESCENT #04-01, NORDCOM 1 SINGAPORE 757088 UEN: 202002819H
Trial Registration Form - All Age Group
CHILD INFORMATION:
Full Child Name*

First NameLast Name
Date of Birth*

DayMonthYear
Male/Female*
Name of School
Name of Academy / Club
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Mobile Number*
E-mail*
Home Address*

Street Address

Street Address Line 2

Postal Code
EMERGENCY INFORMATION:
Emergency Contact

First NameLast Name
Mobile Number
Relationship
MEDICAL INFORMATION:
Does your Child have any allergies, chronic illness, or medical conditions? If yes, please describe.
OTHER INFORMATION:
By submitting the form, I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the Woodlands Lions Football Academy Pte Ltd, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the Woodlands Lions Football Academy Pte Ltd, accepting the registrant for its soccer programs and activities (the "Programs"). I hereby release, discharge and/or otherwise indemnify the Woodlands Lions Football Academy Pte Ltd, its affiliated organizations and sponsors, their employees, coaches and associated personnel, including the owners of fields and facilities utilized for the Programs, against any claimby or on behalf of the registrant as a result of the registrant's participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.
Date

MonthDayYear
Date
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WOODLANDS LIONS FOOTBALL ACADEMY PTE LTD

Trial Registration Form - All Age Group

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION:

EMERGENCY INFORMATION:

MEDICAL INFORMATION:

OTHER INFORMATION: