2016/2017 - Registration Form

8:50am -11am

Parent/Guardian Contact

Email

Contact Number

How many players are you registering?

Player 1 Name & DOB

Player 1 Emergency Contact Number

Player 2 Name & DOB

Player 2 Emergency Contact Number

Player 3 Name & DOB

Player 3 Emergency Contact Number

Player 4 Name & DOB

Player 4 Emergency Contact Number

If you are registering as a team of 3 or 4, please enter your Team Name:

Do you consent for photo's/video's to be taken by UTD Sports and to be published for Social Media

Do any of the players have any medical conditions that we should be aware of?

Product

1 Player£12

2 Players£23

3 Players£34

4 Players£45