Ascend Futsal Academy Trial Form

Futsal Registration

This new project by ASC will be headed by Gillingham FC academy Coach and our Lead Coach Rhys Bailey in aiding children's development and enjoyment using Futsal which will help players ability on the ball while helping their decision making in moments in-game.
The first 2 sessions we offer will be FREE of charge to the players!

Once this form is completed 1 of our coaches will contact with more infomation.
Ascend Sports Coaching Futsal Academy will take at the location below:

Chatham Grammar for Girls, Rainham Road, Chatham, ME5 7EH
Players Information
Players Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Additional Player Information
Name of School
Do you play for a Club?
If Yes, which club?
What position(s) do you play?
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Address (if different from the player's)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Ascend Sports Coaching during the selected activity. In exchange for the acceptance of said child’s candidacy by Ascend Sports Coaching, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Ascend Sports Coaching and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Ascend Sports Coaching, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including Futsal. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Do you agree to the above?
Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

Futsal Registration

Additional Player Information