UITC Soccer Schools Booking Form
Number of Places
Date of Birth
Male / Female
First name, Surname and Date of Birth of any additional registrants
Dietary / Medical Requirements. Any other important information.
Emergency Contact Name
Emergency Phone Number
Parental/Guardian Declaration. I have read and understood this form, completed all details to the best of my knowledge and will ensure I comply with the information given. I acknowledge and accept that UITC or respective servants shall not have any liability in respect of loss or damage to property while attending a UITC course. I hereby give permission for my child to be given emergency medical treatment in my absence if deemed appropriate. Please tick the box to indicate consent.
Should be Empty: