Cumberland United GOALKICK Registration Form

Cumberland United Football Club

GOALKICK Registration Form
The GOALKICK program runs once a term so please check website for confirmation of term commencement dates.

Each program runs for 8 weeks, unless advised otherwise.

The GOALKICK fee is $150 and is payable on the commencement date by cash or card.

Players need to wear shin pads and boots and bring a drink with them.
Which GOALKICK Term program are you registering for;*

Term 1Term 2Term 3Term 4
Player*

First NameLast Name
Birth Year*
Country of Birth*
Primary School*
How did you find out about this program?*
Parent/Guardian 1*

First NameLast Name
Mobile Number*
E-mail*
Parent/Guardian 2

First NameLast Name
Mobile Number
Cumberland United Football Club accepts no responsibility for any costs incurred from injuries. We recommend that players have private medical insurance and ambulance cover.
Parent/Guardian 1 Signature *

Clear
Date*

DayMonthYear
A reminder the GOALKICK fee is $150 and is payable on the commencement date at the club by cash or card, we look forward to seeing you then.
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Cumberland United Football Club