Saturday Football Academy Booking Form 2019/2020

Saturday Football Academy Booking Form

Please complete and submit the booking form below to secure booking

We have been running our Saturday Football Academy for 15 years. Our Coaches are all level 1, 2 & 3 (UEFA B) accredited and are Paediatric First Aid trained and have completed a Child Protection Workshop

Sessions consist of a warm up, skills & drills, football match and penalty shootout

Medals are rewarded for star performers and penalty kings/queens

Please bring with you plenty of fluid, a healthy snack, appropriate footwear and plenty of enthusiasm

This is a Pay as you play session

We run all year round irrespective of the weather

We open the session for all parents to watch their children learn, get fit, make new friends.. and who knows, develop into the next football star!

Boys and Girls aged 4-12 are welcome regardless of footballing ability and experience

Please call 07746 945 903 for more information, otherwise book online now..

Child's Name: *

First Name Last Name

Child's D.O.B: *

Date Date Picker Icon

Child's Age: *

Child's Age

Child's School: *

Name of your child's school

Child's Favourite Team(s): *

Favourite Teams(s)

Does You Child Have Any Football Experience?: *

Yes No

Medical Condition(s): *

Yes No

Details Of Medical Condition(s): *

For example: Hay fever, Asthma

Parent/Guardian Name (1): *

First Name Last Name

Parent/Guardian Name (2): *

First Name Last Name

Parent/Guardian E-mail: *

Emergency contact 1: *

Mobile number

Emergency contact 2: *

Phone number 2

Parent/Guardian Full Address: *

Street Address
Street Address Line 2
City	County
Postcode	Country

Collected By: *

Name of the person collecting your child

Relationship To Child: *

What is their relationship to your child

Security Password: *

Choose a security password of your choice that'll be used if somebody else collects your child

Additional Comments:

Any additional information you would like to tell us? (For example: SEN, Toilet issues, Behaviour issues, etc)

Thank you for completing our online booking form. Please tick and sign below to receive a booking confirmation via email.

Is your child's birthday within the next 3 months? We are offering an exclusive £25 off Birthday Party Bookings to all existing customers. Would you like the Xtra Time team to help plan your child's next birthday party? *

Yes (Contact me) No

Would you be interested in a variety of Private One-to-One / Group Tuition for you or your child? Focusing on upskilling, mental health, well being, weight loss, confidence and more. Please Click here for more information *

Yes (Contact me) No

Do you give consent to Xtra Time Kidz Club to take pictures or videos of your child which will ONLY be used for marketing purposes (Social media platforms, www.xtratime.co.uk, flyers and other advertising purposes)? *

Yes No

I understand that I am not allowed to interfere with the coaching session or encroach on to the pitch whilst the coaches are delivering their sessions. I understand I am not allowed to take pictures or make videos of my child during the session to ensure the safety of all children and coaches.

Yes

Once the submit button has been clicked your booking is being processed. Please do not click the submit button more than once.

GDPR *

YES NO

Date