NEXT LEVEL PRIVATE SESSIONS

Parents’ Declaration form

Name of Parent/Guardian *

First

Last

Name of Child *

First

Last

Age of Child (6-15) *

Gender *

I give permission for the following:

Health Declaration (Any disabilities)

How long has your child played soccer for?

What is your child's preferred playing position?

Which team does your child support (if any)?

Who is your child's favourite player (if any)?

Is your child right, left or two footed?

Other than their overall skill development, is there any particular skill that you would like your child to work on?

Emergency Contact Name #1 *

First

Last

Emergency Contact Phone #1 *

Emergency Contact Name #2 *

First

Last

Emergency Contact Phone #2 *

Permission & Agreement *

I agree that the information stated above is correct and that it may be distributed to Football Life Coaches.

Wet Weather Agreement *

I agree that sessions will continue in the rain. Sessions will only be cancelled when the weather is either unplayable (e.g., hail/heavy rain) or dangerous (e.g., thunder & lightning).

Sickness Agreement *

I agree that as it’s hard to arrange make-up sessions due to sickness/unplayable weather conditions, only 1 Session Credit is given per term. The Session Credit can be used the following term OR a reimbursement can be given for the cancelled session.

Signed (Parent/Guardian Print Name) *

Please contact Coach Louis (0423 488 116) for any enquiries.

Payment can be made to the following bank details:

BSB: 082-356

Account No: 91-847-4074