Anything written on this form will be held in confidence and only used in relation to Gortmerron Soccer Camp.

If sending multiple children please complete a separate form for each child.

Unfortunately numbers will be capped this year, with the first registered children granted a place. When cap is reached we will update this page, but continue to collect details for a waiting list. If spaces become available we will inform you by text message to the Parent/guardian phone number given below.

⚽ Child's details

Child’s Name (required)

Child’s D.O.B. (required)

Age (on 04/08/2024) (required)
*

⚽ Contacts

Parent/guardian phone number

Emergency contact phone number

Phone numbers provided may also be used to inform people on waiting list of available spaces.

If you would like to receive occasional emails regarding events which we think may be of interest to you or your child, such as future years' soccer camps, please provide an email address here.

⚽ Medical

Has your child any medical condition/history of which you feel we should be aware (e.g. asthma, epilepsy, diabetes, allergies)? If so, please give details below:

⚽ Consent

I give permission for my child to attend Gortmerron Soccer Camp and to participate in all its activities. (consent required to attend)
---Consent to child's attendance

I give permission for photographs to be taken of my child at events.
---Consent to photosDo not consent to photos

I also authorise the leader-in-charge to give, on my behalf if I cannot be contacted, consent for any urgent medical attention. However, I understand that every effort will be made to contact me as soon as possible. (consent required to attend)
---Consent to urgent medical attention

⚽ Digital signature

Digital signature (required)

Please type your own name (Parent/Guardian) below in place of a signature.