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February Half Term 2012 If your son/daughter wishes to attend ‘SIMPLY SOCCER/SPORTS’ please complete this application form and disclaimer and return ASAP to guarantee a place as there are limited numbers. Childs Name:

Age:

Yr Group:

Date of Birth: Parent/Guardian Name: Mailing Address:

Postcode: Home Tel:

Work Tel:

Mobile:

Email:

Emergency name and contact number: Any allergies/illnesses (Medication): I understand that Simply Soccer are not under any liability whatsoever in respect of any loss or damage, however caused while attending the soccer school. I confirm that I have read and accepted these conditions. Print Name:

Signed:

Options (Please tick)

February Half term 13th-17th February 2012 Mon - Fri 8.30am – 3.30pm = £80

Individual days = £20

Half days = £10

Please state individual days or half days: Please enclose a cheque for the appropriate amount payable to ‘J Scott & S Moiani’ and send along with the application form to:

Simply Soccer School

3 Les Ormes, La Rue De La Blanch Pierre, St Lawrence JE3 1EX Mob: 07700 8260 382 Email: simon@simplysoccerschool.com

February half term apllication form  
February half term apllication form  

The February half term application form states times, dates and prices available for the next course. If you wish your son/daughter to atten...

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