Book Your Place at The Steve Chettle Soccer School
Ravenshead Leisure Centre
26th & 27th October 2009
(you must fill in all fields on this form to complete online registration)

Registration Options:         
(Drop Down Menu)
Email Address:                   

Child 1 Name:                    

Child 1 Date of Birth:          

Child 2 Name:                    

Child 2 Date of Birth:          

Child 3 Name:                    

Child 3 Date of Birth:          

Address:                              

Postcode:                            

Telephone:                         

Medical Conditions (if any):

Emergency Contact Person:

Relationship to Participant: 

Emergency Telephone No:  

Parent/Guardian Name:       

Do you play for a Team? If so, which one?: 
In case of emergency, S.C.S.S. qualified staff will attend to the players medical needs.
If you do not wish for S.C.S.S. staff to administer Emergency Aid to the
player you are responsible for, put NO FIRST AID in the box  

S.C.S.S. may take photographic or video images of participants under 18 years of age for
future promotional published material. This process may be carried out by a reputable third
party & may also appear on satellite or terrestrial television.
If you do not wish for your child to feature, put NO PHOTOS in the box 




Steve Chettle Development Soccer School Copyright © E.M.S.A. Ltd 2008
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