Course Registration Section

Username *

Password *

Confirm Password *

Centre

BSS York & Ripon

Child's Doctor

Date Joined *

Doctor's Phone

Child's Surname *

Next Of Kin (N0K1)

Child's Forename *

Nok1 Phone Number

Child's Date Of Birth *

Nok1 Mobile Number

Parents's Surname

2nd Next Of Kin (N0K2)

Parents Forename

Nok2 Phone Number

House Name / Number

Nok2 Mobile Number

Street

All children who attend Brazilian Soccer Schools sessions are required to be members of the International Brazilian Soccer Schools Club. Please return this form with your annual membership fee. Please note that all members are subject to terms and conditions that are available separately upon request.

Postal Town

Postcode

Telephone

Insurance: All members over the age of 6 months are automatically insured for personal accident while participating in classes, which is in respect of death, loss of limb and eyes, or permanent total disablement sustained. In addition, members of all ages are covered by public liability insurance.

Mobile

EMail *

Previous Football Experience

Special Needs/Medical Notes: Should your child have any special needs or medical requirements please tick this box.

MEMBERSHIP IS NOT TRANSFERABLE BETWEEN CHILDREN, AND IS NON REFUNDABLE

Data Protection: Please tick this box if you do NOT wish to receive mailings from selected companies.

PARENT/GUARDIAN NON- COMPETITION & CONFIDENTIALITY AGREEMENT

The business of Brazilian Soccer Schools is a soccer specific physical learning concept and a system for school age children and is made up of the training programme, the training sessions, the training manuals and/or training videos which together are called The System.
In consideration for the Company giving you and your child access to The System you agree as follows:
a. To keep The System confidential as well as any information regarding it which is confidential or could reasonably be expected to be confidential and
b. Not to directly or indirectly to copy or use The System or any part of it except as specifically authorised in advance by the Company; and
c. Not directly or indirectly to manage or operate or assist in the organisation of any business which competes with Brazilian Soccer Schools, either while the child is a member of Brazilian Soccer Schools or for a period of three years afterwards.

Photography: By ticking here, I give permission for my child to be photographed for marketing purposes for Brazilian Soccer Schools, and I permit the photographs to be used to positively promote Brazilian Soccer Schools and other affiliated organisation such as the International Confederation of Futebol de Salão.

Prints: By ticking here, I would like to see any photographs of my child at some point soon after the session.