JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
King's Elite Goaltending June 15-16 Junior Camp Romford
Please complete this enrolment form and return to the website to pay the £75 non refundable deposit to confirm your place
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Registration Form
Name Of Student
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Parents/Guardian Name (if applicable)
*
Your answer
Parents/Guardian Email (if 18+ please enter your email address)
*
Your answer
Telephone Number
*
Your answer
Current Team
*
Your answer
Number of years playing experience
*
Your answer
Current Age Group
*
u10s
u12s
u14s
u16s
u18s
Other:
Jersey Size
*
XS
S
M
L
XL
XXL
**Academy members only***. Would you prefer an Academy exclusive jersey or a camp design jersey?
Academy
Camp
Clear selection
Emergency Contact and Contact Number
*
Your answer
Relationship to the student
*
Your answer
Medical History
*
Asthma
Diabetes
Epilepsy
Heart Condition
Allergies
None of the Above
Other:
Do you regularly take or require any medication whilst participating in sport? If yes please provide details along with medication used:
*
Your answer
Any History of Concussion, Head or Neck injuries in the past 3 years
*
Your answer
Any other Injuries we should know about
*
Your answer
Do you have any other illness/ injuries that may prevent or affect participation in the camp? If yes, please provide details:
*
Your answer
I give consent for photos and videos to be taken during the camp for promotional purposes
*
Yes
No
I have read and accept the King's Elite Goaltending camp T&C's and GDPR Statement -
https://www.kingselitegoaltending.com/camp-legal-documents
*
Yes
No
Signed
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of King's Elite Goaltending.
Report Abuse
Forms
