GIRLS ONLY
JUNIOR FUTSAL TRAINING
Parent Name
*
First Name
Last Name
Child Name
*
First Name
Last Name
Child DOB
*
-
Day
-
Month
Year
Date
Playing Experience
New players only
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
What night are you registering for?
*
Please Select
Tuesday Night
Thursday Night
If you have a sibling who will be attending, please list their name/s & DOB here.
I hereby grant permission to Sala Time FC representatives, to take and use photographs and/or digital images of me or my child for use in: 1. Media releases, media articles – including newspapers, radio, television – printed publications and/or educational materials relevant to Sala Time Fc. 2. Electronic publications and communications such as the Sala Time Facebook & Instagram pages and website.
*
Yes
No
I hereby authorise for medical assistance to be obtained for my child if required in the event of an accident, illness or injury
*
Yes
No
If you would like to purchase a kit (which includes shirt, shorts & socks) please advise the size below. These are optional and cost $55 (reduced down from $75) due to our generous sponsors. If so, please add the $55 to your amount owed below.
Submit
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