Cassiobury - Saturday / Sunday Football Academy Booking Form 2019

Bellmount Wood Avenue, Watford, WD17 3PD.

Please complete and submit the booking form below to secure booking.

We have been running our Saturday Football Academy for 21 years. Our Coaches are all level 1, 2 & 3 (UEFA B) accredited and are Paediatric First Aid trained and have completed a Child Protection Workshop

10am-12pm (£14 per session) & 10am-12pm

Sessions consist of a warm up, skills & drills, football match and penalty shootout

Medals are rewarded for star performers and penalty kings/queens

Please bring with you plenty of fluid, a healthy snack, appropriate footwear and plenty of enthusiasm

This is a Pay as you play session

We run all year round irrespective of the weather

We open the session for all parents to watch their children learn, get fit, make new friends.. and who knows, develop into the next football star!

Boys and Girls aged 3-13 are welcome regardless of footballing ability and experience

Please call 07746 945 903 for more information, otherwise book online now.

Venue: (Please contact us before your visit to see if the session is running at your chosen venue).*

Cassiobury Junior School

Child's Name:*

First NameLast Name

Child's D.O.B:*

Date

Child's Age:*

Child's Age

Child's School:*

Name of your child's school

Child's Favourite Team(s):*

Favourite Teams(s)

Does You Child Have Any Football Experience?:*

YesNo

Medical Condition(s) and / or SEN?:*

YesNo

Details Of Medical Condition(s) and / or SEN:*

For example: Hay fever, Asthma

Parent/Guardian Name (1):*

First NameLast Name

Parent/Guardian Name (2):*

First NameLast Name

Parent/Guardian E-mail:*

Emergency contact 1:*

Mobile number

Emergency contact 2:*

Phone number 2

Parent/Guardian Full Address:*

Street Address

Street Address Line 2

CityCounty

Postcode

Due to Covid restrictions, we kindly ask all parents to drop off and collect your child / children at the gates of the main entrance of the session.

Collected By:*

Name of the person collecting your child

Relationship To Child:*

What is their relationship to your child

Security Password:*

Choose a security password of your choice that'll be used if somebody else collects your child

Additional Comments:

Any additional information you would like to tell us? (For example: SEN, Toilet issues, Behaviour issues, etc)

Did you know we do Birthday Parties?

Is your child's birthday within the next 3 months? We are offering an exclusive £25 off Birthday Party Bookings to all existing customers. Visit our Birthday Party Form by clicking here and a member of our team will be in touch with you.

Did you know we do Private One-to-One / Group Tuition?

Would you be interested in a variety of Private One-to-One / Group Tuition for you or your child? Focusing on upskilling, mental health, well being, weight loss, confidence and more. Visit our Private 1-to-1 / Group Tuition Booking Form by clicking here and a member of our team will be in touch with you.

Thank you for completing our online booking form. Please tick and sign below to receive a booking confirmation via email.

Do you give consent to Xtra Time Kidz Club to take pictures or videos of your child which will ONLY be used for marketing purposes (Social media platforms, www.xtratime.co.uk, flyers and other advertising purposes)?*

YesNo

I understand that I am not allowed to interfere with the coaching session or encroach on to the pitch whilst the coaches are delivering their sessions. I understand I am not allowed to take pictures or make videos of my child during the session to ensure the safety of all children and coaches.

Yes

Once the submit button has been clicked your booking is being processed. Please do not click the submit button more than once.

Date