SBD School Holiday Clinic Enrolment Form

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School Holiday Clinic - Reynella East College08:30AM - 12:00PM (7-15 years)

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Player Name* This field is required.

First Name

Last Name

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Date of Birth* This field is required.

Date

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Current Age* This field is required.

5

Gender* This field is required.

Male

Female

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How many years of experience does the player have?* This field is required.

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At which academy/club/school did the player gain this experience?* This field is required.

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Does the player have any pre-existing medical conditions* This field is required.

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Do you consent to your child being photographed or recorded for use in Soccer By Design’s promotional materials, including social media and our website?* This field is required.(If you select No, please confirm in writing via email to accounts@soccerbydesign.com.au)

YESNO

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Do you consent to Soccer By Design seeking medical treatment for your child, including calling an ambulance if required, and accept responsibility for any associated costs?* This field is required.(If you select No, please confirm in writing via email to accounts@soccerbydesign.com.au)

YESNO

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I understand that participation in soccer and related activities involves a degree of risk and agree that Soccer By Design, its staff, and volunteers are not liable for any injury, loss, or damage, except where required by law.* This field is required.(If you select No, please confirm in writing via email to accounts@soccerbydesign.com.au)

YESNO

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Parents Name* This field is required.

First Name

Last Name

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Phone Number* This field is required.

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Email* This field is required.

example@example.com

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Todays Date

Date