HERFOOTBALLCOACH Holiday Camp Registration Form 🌟

Child Name

First NameLast Name

Child Date of Birth

MonthDayYear

Current club & level (Community or Academy)

What age group do they play in? Eg. U14's

Experience level?

Parent Contact Name

First NameLast Name

Parent Contact Phone

Format: (000) 000-0000.

Parent Contact E-mail

example@example.com

Emergency Contact

First NameLast Name

Emergency contact relation to player?

Emergency Contact Phone

Format: (000) 000-0000.

Emergency Contact E-mail

example@example.com

Does your child attend school in NSW OR QLD?

Camp dates attending?

If you are attending only ONE out of a two day camp please select below

Does your child suffer from Asthma?

Does your child suffer from Epilepsy?

Please list Allergies

Please list

Injuries / existing physical limitations

Additional Medical conditions please list below: Eg. Diabetes etc...

Photo and video consent — are you happy for your child to be photographed or filmed for use on HERFOOTBALLCOACH social media and promotional material?

Liability Waiver & Acknowledgement of Risk: I acknowledge that participation in football and physical activity involves inherent risks, including but not limited to slips, falls, collisions, strains, sprains, and other injuries. I confirm that my child is medically fit to participate in the HerFootballCoach Holiday Camp and that I have disclosed any relevant medical conditions, injuries, allergies, or health concerns.I understand that while HerFootballCoach will take all reasonable precautions to provide a safe environment, participation is undertaken at my child's own risk. To the fullest extent permitted by law, I release and hold harmless HerFootballCoach, its coaches, staff, volunteers, and venue providers from any liability arising from injury, loss, damage, or expense incurred through participation in the holiday camp, except where caused by negligence.

Confirmation that the information provided is accurate to the best of their knowledge

Players will receive a payment link within 48hrs of submitting this form. This ensures we can check if discounts apply and registrations align.

*Please note players will not be successfully registered to attend HERFOOTBALLCOACH holiday camp until payment has been confirmed*

PRICING:

- 1 x HOLIDAY CAMP - (2 DAYS) / $100

- 1 HOLIDAY CAMP INDIVIDUAL DAY (1 DAY ONLY) / $65

- 1 x HOLIDAY CAMP *TWEED UNITED PLAYER* - (2 DAYS) / $80

- 1 HOLIDAY CAMP INDIVIDUAL DAY *TWEED UNITED PLAYER* (1 DAY ONLY) / $52