Football Form

Fields marked with * must be completed.
Childs Name*
Date of birth
Date
Telephone Number* Mobile Number*
Address*
Postcode*
Email*
Venue*
Time*
Please state any relevant medical condition or allergies*
Glasgow Young Scot or Kidz Card number
Parent/Guardian Name*
Date*
Date
I acknowledge and accept that Glasgow Life, or the organisation providing facilities and their respective agents, servants or employees, are not under any liability whatsoever in respect of personal injury, loss or damage however caused whilst in attendance of the above soccer course(s).
All courses are provided by Glasgow Life.
Cheques should be made payable to Culture and Sport Glasgow
I agree to my son/daughter* participating the above activity.
I consider that my son/daughter* is in good health and capable of taking part in this activity.
I acknowledge the requirement of my son/daughters* to behave responsibility during this activity.
I agree to my son/daughter* being filmed or photographed with the possibility that these photographs/recordings may be used for publication and/or publicity.
In the event of an emergency I consent to any emergency medical/dental treatment that my son/daughter* may require prior to my arrival.
*if other relationship please state
Please note: Failure to adhere to the above terms and conditions may result in failure to secure a place on course of choice.