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All trials must be conducted consecutively. No refunds on trials.

PARENT / CHILD DETAILS

Full Name of Parent / Guardian:	*
Address:	*
Suburb:	*
State:	*
Postcode:	*
Home Telephone Number:	03 *
Mobile Number:	*
Email:	*
Child's Full Name:	*
Male / Female:	*
Date of birth:	*
Age:	*
Additional child (optional):	*
Child's Full Name:	*
Male / Female:	*
Date of birth:	*
Age:	*
Child's Full Name:	*
Male / Female:	*
Date of birth:	*
Age:	*

PROGRAMME DETAILS

Interested Programme:	*
Preferred Suburb Area:	*
When would you like to start:	*
Comment:
Any medical conditions?:	Yes No
If Yes, please specify:
Where did you hear about us:
*Terms and Conditions: I give permission for my child to attend and participate in all activities in the Footy Kids programme. All care and caution is taken at all times but as of mishap, Footy Kids cannot accept liability for any injury that may occur whilst participating in one of our coaching/education programmes. Parents/Guardians and children participate at their own risk and shall indemnify Footy Kids and its staff against all actions, suits, proceedings, demands, costs and expenses which may be taken or made against Footy Kids which may arise from injury, illness or mishap. Footy Kids cannot be held responsible for any loss or damage to any personal belongings while attending one of our coaching/education programmes. Any medical conditions that a participant may have must be fully disclosed to Footy Kids. Footy Kids operates a no-refund policy. Unless under extreme medical conditions. If for any reason you are not able to attend a session then a make up class can be made, if there are positions available in another class (we cannot guarantee a class). Arrangement must be made with Footy Kids prior to attending another class. Footy Kids management may occasionally take photos or video footage for promotional purposes, so please advise management if you would not like your childs image used in promotional purposes.

I have read and accept the above terms and conditions.
* Represents mandatory field