Please fill in and return this form to the address below. BSS Godalming, 2 Pewtrees Cottages, Lower Eashing, Godalming GU7 2QD t: 01483 416002 e:
[email protected] website: www.icfds.com/guildford All children must be pre-booked before attending. Your Child's Information
Child 1
Child 2
Forename Surname Date of Birth Emergency Contact Number:
Parent/Guardian Information Parent/Guardian's Title: Mr/Mrs/Ms/Miss
Forename
Surname
Address
Postcode Telephone numbers:
Daytime
E-mail address:
Evening How did you hear about the Brazilian Soccer School?
What most interested you about the Brazilian Soccer School? Membership details Venue:
Broadwater School - £5 a session
Membership Pack
Tuesday:
18:30 - 20:00 Core session
1 x Nike BSS Training Shirt 1 x BSS Guildford folder
17:30 - 18:15
Membership costs £25 and is compulsory after 4 weeks
Junior BSS
Tuesday:
Sessions booking onto: Preferred method of payment Bank Transfer Cheque Cash Paypal
BSS Guildford Bank Details Natwest, Guildford High Street GU1 3AH Sortcode: 60-09-21 Acct: 74577239 Include ref: BSS (child's name & hours) Paypal payments to
[email protected]
(Please delete as necessary) I DO/DO NOT give permission for any photo's to be taken of my child/ren during the course to be used for promotional/marketing material.
BOOKING TERMS AND CONDITIONS I have read and understood this form, completed all the details requested to the best of my knowledge. (1) All fees are payable in agreement with this form and are only refundable by credit - 30 days notice must be given before cancelling further payments (2) All coaches are qualfied andhave had full C.R.B. checks completed. (3) BSS is not responsible for any loss or damage to personal belongings or effects. (4) You agree to keep BSS training system confidential and to not directly or indirectly copy or use the BSS system; and you also agree to not directly or indirectly manage or operate or assist in the organisation of any business which competes with BSS either while the child is a member of BSS or for a period of three years afterwards.(5) I agree that only the child who is on the above form will be insured by BSS. Extra children attending will not be covered
Must be signed by parent/guardian before attending please. Signed by Parent/Guardian Print Name:
Total Enclosed: £ Date: