Parental Consent & Registration Form

A Different Way, Instilling a love of sport ensuring life long participation. 

Following your child's free tasters we hope that you entrust us with the development of your child, it is a responsibility we do not take lightly. On your child completing their two free taster sessions you will receive an estimate of your monthly fees together with full membership details.


Childs Details
First Name
Last Name
Date of birth *
Date of birth
Playing Experience
Parent/Carer Details
Parent/Carer Name *
Parent/Carer Name
Address
Medical & Emergency Details
Please provide contact details different to those provided above incase we are unable to reach you.
Emergency Contact Name *
Emergency Contact Name
Membership Fees *
Please tick the payment schedule you would like for your child's membership. (Please note all payments are done by standing order and there is a minimum 12 week commitment)
Kit Options *
Please select the kit option you would like, you receive 10% off all kit if bought on joining
Signature
Data Protection: Data Protection: Your information will be used by The Futsal Partnership for the purpose of compiling course registers, Your information will NOT be given to third parties, We will send you further information regarding your membership to the email given above, Photographs may be taken and used by The Futsal Partnership for marketing purposes. It is your responsibility to ensure your child is dropped off and collected by a parent or guardian prior to leaving the venue at any of our sessions or holiday weeks, we will do our upmost to ensure this
Signed *
I can confirm that I agree with the above terms and conditions and by clicking Submit I am electronically signing the consent form