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KL FOOTBALL SUMMER SOCCER CAMP REGISTRATION FORM JULY 2022
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Email
*
Your email
Child Full Name
*
Your answer
Child Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Boy
Girl
I consent, on my child's behalf, to the use of photographic or video material of my child only to be used by KL Football & McKelvey Celtic Football Club and its programme sponsor for promotional purposes.
Yes I consent
Does your child have any additional needs? If so please specify
*
Your answer
Does your child have any medical conditions that we may need to be aware of? If so please specify
*
Your answer
Primary Guardian Full Name
*
Your answer
Primary Guardian Phone
*
Your answer
Primary Guardian Alternative Phone
*
Your answer
Alternative Guardian Full Name
*
Your answer
Day Time Contact Number
*
Your answer
Secondary Contact Number
*
Your answer
Address
*
Your answer
Primary Email
*
Your answer
I consent to be contacted by email regarding future KL Football Camps/ Coaching Clinics
Yes I consent
Childs T Shirt Size
xs
S
M
L
XL
Week of Choice
*
Mon 4th July-Fri 8th July
Mon 25th July-Fri 29th July
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