GK Session Sign Up Form

Player's Details

Child's First Name

Child's Last Name

Child's Date of Birth

Day

Month

Year

Child's Address

Country/Region

Address

City

Zip / Postal code

Child's Gender

Child's Current School

Child's School Year & Age Group

Child's Current Team (If Applicable)

Are there any medical conditions, needs or special requirements that we need to be aware of?

For example: Asthma, Physical impairments etc

What session(s) are you interested in?

Clissold Park Group GK Session, Sundays 12:30-1:30 (Years 1-5)

Clissold Park Group GK Session, Sundays 1:30-2:30 (Years 6-9)

Market Road Group GK Session, Wednesdays 5:00-6:00 (Years 1-5) COMING SOON

Market Road Group GK Session, Wednesdays 6:00-7:00 (Years 6-11) COMING SOON

Personal Sessions (1:1 sessions and small group sessions)

Parent/Guardian Details

Parent/Guardian's First Name(s)

2nd Parent/Guardian's First Name(s)

Relation To Child

Parent/Guardian's Last Name

2nd Parent/Guardian's Last Name

Phone Number

Do you consent to using photos or videos of your child for purposes including posting to our official social media accounts, marketing materials, website content?

Yes

*Please note that this consent can be withdrawn at anytime by emailing Malik at malikmaactive@gmail.com

Keep up to Date - I Would you like to receive our latest news, updates, and information about MA Active?

Yes, I agree to receive communications via email and SMS.

No, I do not want to receive these communications.

Any Other Comments...