FORM FOR INDIVIDUAL (GROUP) SESSION CIFA ELITE PORTUGAL 1 ON 1

Medical conditions we need to be aware of (optional)

PLAYER 2

First Name

Last Name

Birth Date

DayMonthYear

Phone Number

Area CodePhone Number

Player E-mail adress

example@example.com

Do you currently play for a club, if so team & position?

Name of the parent/tutor and emergency contact name

First NameMiddle NameLast Name

Phone Number

Area CodePhone Number

Parent/Tutor/Emergency contact E-mail

example@example.com

Medical conditions we need to be aware of (optional)

PLAYER 3

First Name

Last Name

Birth Date

DayMonthYear

Phone Number

Area CodePhone Number

Player E-mail adress

example@example.com

Do you currently play for a club, if so team & position?

Name of the parent/tutor and emergency contact name

First NameMiddle NameLast Name

Phone Number

Area CodePhone Number

Parent/Tutor/Emergency contact E-mail

example@example.com

Medical conditions we need to be aware of (optional)

PLAYER 4

First Name

Last Name

Birth Date

DayMonthYear

Phone Number

Area CodePhone Number

Player E-mail adress

example@example.com

Do you currently play for a club, if so team & position?

Name of the parent/tutor and emergency contact name

First NameMiddle NameLast Name

Phone Number

Area CodePhone Number

Parent/Tutor/Emergency contact E-mail

example@example.com

Medical conditions we need to be aware of (optional)

From time to time the team/club may wish to take pictures for promotional use in local, regional or national media to promote the work of the team/club. Any photographs taken will be used solely for promotional purposes. Please select below to indicate your agreement for pictures to be taken for the above reasons.*

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ACCEPTANCE FORM