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] (U5 Colpetty)
Thursday [3PM - 4PM] (Colpetty)
Friday [3PM - 4PM] (Colpetty)
Saturday Morning [8AM - 9AM] (Col 07)
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.
How did you hear about us?
Instagram / Facebook
Word of Mouth
Google Search
website Visit
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
Photo & Video Consent
I consent to my child being included in photographs and videos taken during Academy activities, which may be used by the Academy for promotional, marketing, and communication purposes, including social media and other Academy publications.
Referral Code (Optional)
Submit
Should be Empty: