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Child’s first name: Child’s surname: Male


Current school year: Date of birth: School: Club:


Name of Parent/Guardian:

Sports Academy 2011

Correspondence Address:

Post Code: Home telephone:

Work telephone:



Please select the course you would like to book:

Rugby Academy with Dean Ryan (1-4 August)

Cricket Academy with Graham Thorpe (25 – 28 July)

Netball Academy with Tamsin Greenway (25 – 28 July)

Hockey Academy with Mark Pearn (25 – 28 July)

Hockey Academy with Mark Pearn (1 – 4 August)

Golf Academy with David Rennie (25 – 28 July)

Payment details A deposit of £75 is requested to reserve the place. An invoice will be sent for the balance towards the end of June. I enclose a deposit of £75 made payable to Independent Coach Education

Independent Coach Education, Helm Bank, Kendal LA9 7PS Telephone: 015395 60060 Fax: 015395 60009 Email:

Wellington Booking Form.pdf