Football Course

Participant’s Full Name:

Daytime:

BY COMPLETING YOUR PURCHASE YOU ARE YOU GIVE PARENTAL CONSENT

You will be indicating your consent for images taken at the football courses being used by Football 2000 and its partner companies formedia and promotional material.

I authorise coaching staff to administer or approve any medical treatment deemed necessary. I agree that the Football 2000 reserve the right to remove any

disruptive children from the course and that the Football 2000 or the host venue do not accept responsibility for loss or damage whether to person or property in connection with these courses.

Application must be made on the form below, Football 2000 reserve the right to change any aspect of the course Including cancellation which credit

notes will be issued which can be used for future courses, other Terms & Conditions may apply.

There will be no confirmation of booking, if you require confirmation please contact the office.

Please select number of Days you would like to attend:

Enter Date Of Birth (DD/MM/YY):

School Attends:

Please enter any medical history or mediation details:

Contact Numbers (please include area code):

Evening:

Please enter the dates you would like to attend: