October Holiday Camps
Scorer Football Academy
Name of Child
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone
*
Email
*
example@example.com
Dates you wish to attend (Week One).
Tuesday 20th October
Wednesday 21st October
Thursday 22nd October
Dates you wish to attend (Week Two).
Tuesday 27th October
Wednesday 28th October
Thursday 29th October
Does your child have photo consent?
Yes
No
Does your child have any access/support requirements you would like us to be aware of?
*
Does your child have any allergies? If so, please state
*
In the event of a medical emergency, do you give consent for our qualified First Aid coaches to provide any medical treatment that may be required.
*
Yes
No
How would you like to make payment?
*
Cash in advance (£20 per day)
Cash on the day (£20 per day)
Do you have any other information not on this form that you would like us to be aware of?
Submit
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