FBL Under 7 Registration Form
Juniors Age Group ( Ages 3 - 6 years )
Participant Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Day/Days you will be attending :
*
Monday [4PM - 5PM] (Col 07)
Tuesday [3PM - 4PM] (Colpetty)
Wednesday [4PM - 5PM] (NAWALA)
Wednesday [4PM - 5PM] COLPETTY
Friday [3PM - 4PM] (Colpetty)
Saturday Morning [8AM - 9AM] (Col 07)
Saturday Morning [9AM - 10AM] NAWALA
Saturday Morning [10AM - 11AM] Boralesgamuwa
Saturday Evening [4:30PM - 5:30PM] (Col 07)
Sunday [3PM - 4PM] (NAWALA)
Current School/Pre-School
Does your child have any medical conditions we need to be aware of ?
*
Yes
No
If yes, please provide details e.g. asthma, allergies, injuries etc.
Parent/Guardian Name
*
First Name
Last Name
Email
example@example.com
Parent/Guardian Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Disclaimer
To the best of my knowledge, my child is in good physical condition and fully able to participate in the academy’s sessions. I am fully aware of the risks and hazards connected with the participation of my child, and herby elect for my child to voluntarily participate in the academy’s training sessions. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, that may be sustained by me/my child, or loss or damage to property owned by me/my child, as a result of my child’s participation. I hereby release the coaching academy, its coaches and employees from any claims of injury that may be sustained while participating in the program.
Consent
*
I am the parent/guardian of the player and I am happy with the above disclaimer and consent to them participating in the academy’s sessions
Referral Code (Optional)
Submit
Should be Empty: