Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Parent / Guardian Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Which training sessions are you able to commit to attending?

Under 13s - Wednesdays at 5.00 pm till 5.45 pm. Cost €7.50 per session.

Under 18s - Wednesdays at 5.45 pm till 7.00 pm. Cost €10.00 per session.

Under 13s - Saturdays at 9.00 am till 9.45 am. Cost €7.50 per session.

Under 18s - Saturdays at 9.45 am till 11.00 am. Cost €10.00 per session.

Does your child have any medical conditions or allergies, we should be aware of? *

Yes

No

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

Country

(###)

###

####

Consent for my child's photo to be used in marketing and social media feeds for Vipers Netball Club.

Yes

No

Waiver *

I have the read the Waiver, linked above and I hereby consent to the participation of my child named above in netball activities organised by Vipers Netball Club. I have read and understood the terms of this waiver of liability and assumption of risk and I voluntarily agree to be bound by its terms on behalf of my child.

Yes

No