Player Development Camp

Kindly fill the form below to register for Player Development Camp

Participant Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Country

Contact Number *

Email *

Age Group *

Date of Birth

Height (cm)

Weight (kg)

What are you interested in *

Emergency Contact/ Next of Kin

Next of Kin Name *

First

Last

Next of Kin Address *

Next of Kin Phone Number

Next of Kin Email *

Relationship *

Medical Information

Is the player recieving any medical treatment? if yes, kindly provide details below

Is the player taking any medication? if yes, kindly provide details below

Does the player have any allegies? if yes, kndly provide details below

PARENTAL CONSENT

This form MUST be completed by both the participant and parent or guardian or the sponsor. Otherwise, the participant will not be permitted to take part in the activity. The participant’s safety is our priority therefore SportEdu+ and Southampton FC (SFC). reserve the right to withdraw any participant from the event on medical grounds at any time. Data collected of your ward shall be treated with absolute confidentiality

Declaration

I being the parent/guardian/sponsor/of the above-named participant declare that my ward is fully fit to participate in the activity organized by SportEdu+ and Southampton FC (SFC). In the event of any injury sustained whilst taking part in the activity during the period, I agree that neither SportEdu+ nor SFC has any liability or responsibility other than providing emergency first-aid treatment as deemed necessary by the medical staff. This treatment will cease at the end of his/her engagement with the activity. I accept that the information provided in this form may be shared with the SFC in order to create a statistical record or future promotions related to SportEdu+/SFC activities. Photos taken and video recordings of my ward during the activity may be used in the dissemination of the activity.

Training

Player Development

Soccer Clinics & Academy

UK Education Scheme

Player Development Camp