Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child's name *

First Name

Last Name

1. Child's date of birth *

MM

DD

YYYY

2. How much football has your child played previously? *

Please select 1 option only

Never

1-12 months

1-2 years

2-3 years

3+ years

3. What would you like your child to develop the most? *

Please select 1 or more options as appropriate

Individual skills and ball control

Passing and teamwork

Confidence and making friends

Being active and having fun

Other (please state within additional information box below)

4. Does your child have any additional support needs we should be made aware of? *

Please select 1 option

Yes

No

Prefer not to say

6. You are happy for your child to be included within the photo's and video's being taken on the day for marketing purposes? *

We will be taking photo's and video's on the day, which will be used as part of our marketing campaign to help us raise the awareness of our programme and get more children active. All content will strictly be used for marketing purposes and will securely remain the property of Football 2 Music Ltd. All photo's and video's will be taken using professional licensed content creators and/or a dedicated Football 2 Music Ltd mobile or tablet device. All authorised members will be identifiable by uniform and/or ID badge.

I agree