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Registration information
Childs Name:
Childs Date of Birth:
Parent / Guardian Name/s:
Parent / Guardian Address:
Email Address:
Mobile Number
Does your child have a medical condition? CHOOSE A SELECTION
If YES Please Supply Medical condition details:
Does your child have any allergies? CHOOSE A SELECTION
If YES Please Supply Allergy details: CHOOSE A SELECTION
Does your child have any special needs that our staff should be aware of? CHOOSE A SELECTION
If YES Please Supply Special Needs details: CHOOSE A SELECTION
Select Preferred Venue:
Select Tuesday Time (Pick one day and one time. Unless paying €259 for two days a week).
9-12 Years 4:30-5:30pm
13-16 Years 5:30-6:30pm
Select Wednesday Time (Pick one day and one time. Unless paying €259 for two days a week).
9-12 Years 4:30-5:30pm
13-16 Years 5:30-6:30pm
I give permission for my child to be given medical treatment either by way of first aid by a suitably qualified person or by a doctor:
I give permission to bring my child to a hospital or doctor in the case of emergency:
I give my permission for my child to be photographed / filmed for promotional purposes on our website and social media platforms:
Randz Academy cannot accept responsibility for injuries that may occur as a result of academy training or games/matches:
I give Randz Academy permission to store my details confidentially:
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