Clinic Details & Booking Form


July Clinic Now Enrolling. Bathurst Street Park, Monday 9th July to Thursday 12th July 2007

 

The Industrie PT are excited to offer a unique and innovative soccer clinic for both the April and July school holidays. Aimed at the 8-14 year old age group for boys and 10-16 year old age group for girls, we have designed a 4-day Soccer program focussing on:


1. Having Fun

2. Passing and Receiving Technique

3. Ball Mastery (Including Tips and Tricks)

4. Game Play (Attack and Defence)

5. Agility and Speed

6. Balance and Co-ordination

7. Running Technique

 

The Industrie PT Clinics general details (When Available, Dates Are Published Here),

 

1. Run From A Monday To Thursday, 9:00am-12:30pm

2. $135.00 per child

3. T-Shirt and Ball

4. Certificate Of Participation

5. Drinks and Equipment Provided

6. Where possible, coaches and parents are encouraged to watch our sessions to gain

    idea's

Booking Form  

Childs Full Name:

  Childs Date Of Birth:
  Parent/Guardian's Name:
  Who Do We Contact In Case Of An Emergency?
  Parent/Guardian's Name:
  Mobile No:

Home/Work No:

 

Relationship To Child:

 

Email Address:

 

Medical Questionnaire

 

Does Your Child Suffer From:

Asthma  Epilepsy  Diabetes

  Do They Require Any Medication While At The Clinic: Tick For Yes, Blank For No
  Are There Any Pre-existing Medical Conditions We Should Be Aware Of: Tick For Yes, Blank For No
  Does Your Child Suffer From Allergies: Tick For Yes, Blank For No

 

Please State Details Of Medications And Medical Conditions We Need To Be Aware Of:

 

By clicking 'I Accept', you confirm that,

1. all the above information is true and correct

2. you are the legal guardian or parent of the child stated in this form

3. you give them your full permission to attend the clinic

4. whilst all care is given to your child while at the clinic, you also agree, The Industrie PT will not be held liable for, any injuries sustained or costs incurred. Furthermore, you agree to waiver all rights to any future claims, whatsoever against The Industrie PT.

 

I Accept

I Do Not Accept

I Will Pay Now ($135.00) By Credit Card

I Will Pay Cash On The Starting Day

    

   
   
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