Please complete the form below

Student Details

Student Name

First Name

Last Name

Date of Birth

YYYY

Training Sessions(s) per week

Please select which training option you would like your Son/Daughter to attend!

Which day(s) of the week?

Please specify which day!

Gender

School

Parent/Guardians Details

Parent/Guardian 1 - Name

First Name

Last Name

Contact Phone

Email Address

Additional Parent/Guardian Info - Please complete if you would like more than one parent/guardian to receive emails, information and updates from ESG!

Parent/Guardian 2 - Name

First Name

Last Name

Contact Phone

Email Address

Student Health Information

Allergies

Medications

Emergency Contact Details - Please enter "same as above" if information is same as parent/guardian listed above!

Contact Name

First Name

Last Name

Contact Number

Relation

By submitting this form you agree to the following and all ESG terms & conditions.

PARENT/GUARDIAN AGREEMENT:

I AGREE TO SEND MY SON/GIRL TO ESG FOOTBALL ACADEMY

I AGREE TO PAY ALL FEES PRIOR TO MY CHILDS PARTICIPATION

I AGREE TO COLLECT MY SON/DAUGHTER FROM THEIR SESSION ON TIME AS ESG FOOTBALL ACADEMY STAFF WILL NOT BE RESPONSIBLE FOR THEM UP TO 15 MINUTES AFTER THEIR SESSION HAS FINISHED

I UNDERSTAND THAT ESG FOOTBALL ACADEMY STAFF WILL PROVIDE FIRST AID IN THE EVENT OF ANY INJURIES CAUSED DURING THE TRAINING SESSION BUT WILL NOT BE RESPONSIBLE FOR ANY SUCH INJURIES CAUSED OUTSIDE

I UNDERSTAND ONCE PAYMENT HAS BEEN MADE, REFUNDS WILL NOT BE ISSUED BY ESG FOOTBALL ACADEMY *