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King's Elite Goaltending Academy
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Enrolment Form
What package have you signed up for?
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Gold
Silver
Bronze
Name of Student
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Your answer
Date of Birth of Student
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MM
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DD
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Address (including postcode)
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Your answer
Club Team
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Your answer
What level of hockey have you played?
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Club
Conference
England/Scotland
Great Britain
Other:
Parent/Guardian name (if under 18)
Your answer
Contact email address (should be parent/guardian if student is under 18)
*
Your answer
Contact Number (should be parent/guardian if student is under 18)
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Your answer
Parental Consent and confirmation you will be present in the room for all 1:1 calls and webinars (under 18s only)
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Yes
Required
Medical History
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Asthma
Diabetes
Epilepsy
Heart Condition
None
Other
If other, please provide more details
Your answer
Do you have any other illnesses/ injuries that may prevent or affect participation? If yes, please provide details:
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I have read and accepted the Term and Conditions laid out on our website
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Yes
Required
I have read and accept our privacy policy and GDPR statement laid out on our website
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Yes
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Please print and sign, or digitally sign, the Code of Conduct found on our website and email to
admin@kingselitegoaltending.com
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Yes
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By signing this form, you confirm that all information is accurate and correct; and you agree to all Terms & Conditions as detailed on our website. Please enter your name below (if under 18, must be signed by a parent/guardian)
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