TERM 4 REGISTRATION

Begins week of Monday 25th October - Ends week of Monday 13th December

SECTION 1 CHILD'S DETAILS

Gender:



Does your child have any medical considerations (e.g. asthma, epilepsy, anaphylaxis) or special circumstances (e.g. custody issues) that we should know about?



SECTION 2 DAYS & TIMES - Please select one or more of the following sessions - age brackets are a guideline only

8 - 9 year old sessions



10 - 12 year old sessions




13-16 year old sessions (Friday session is now full)




What are the main reasons for registering your child with Northland Futsal Academy?





SECTION 3 PARENT/CAREGIVER DETAILS

MEDIA RELEASE

I give my permission for my child's photo to be used for promotional and/or coaching purposes on Northland Futsal Academy Limited's Facebook page and/or website.



How did you hear about us?







SECTION 4 PRICES & PAYMENT OPTIONS

Term 4 fees - $125.00 or $230 for 2 sessions per week.

Payment can be made by cash or bank transfer.

* Account details: Northland Futsal Academy Ltd - Acc # 38-9017-0827021-00 Reference: 1st Initial/surname. Code: Term 4

I will make payment by



SECTION 5 T&Cs

* I accept that all foreseeable risks and hazards have been identified and either minimised or eliminated and that Northland Futsal Academy is not liable for any injuries sustained to my child while in attendance at a Northland Futsal Academy training. (Our Health & Safety Policy and Risk Management information is available for you to read at our training sessions). * I give my permission for my child to be attended to by a certified 1st aider and/or emergency services in case of an emergency. (Note: All NFA staff have a current 1st aid certificate).