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HTAFC TERRIER TOTS!

for ages 2 to 4 year olds

all staff are qualified coaches, CRB and First Aid qualified
A, B, Cs of movement, agility, balance, co-ordination and speed

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D ISAPPO INTM NTELCO ME.
PARENTS ARE W

3
per
session
Mondays and Fridays
Football Sessions!
Appearances from Terry the Terrier and prizes to be given!

12:30 pm to 1:30 pm Mondays


1 pm to 2 pm Fridays
at The Zone Huddersfield Community Trust
Off ST Andrews Road - HD1 6PT

FUN-DAMENTALS OF FOOTBALL!

Bookings and information

dane.murphy@thezone.uk.com 01484 484 134


facebook.com/thezonehct
twitter.com/thezonehct

APPLICATION FORM CAPITAL LETTERS REQUIRED


Child Details

C ourse code(s), name(s) if any ...........COACHING CLINICS.....................................

Child Address .......................................................... Postcode ............................................


Child's name ............................................................ Date of Birth ..................................... Age.....................
Male / Female ..........................................................
Medical issues .......................................................................................................................................................
..................................................................................................................................................................................

Parent / Guardian Details

Name ...................................................................... Email ....................................................................................


Adress ...................................................................................................................... Postcode ...........................
Contact numbers: Day ................................................................ Night ...........................................................

Payment Details

Credit / Debit Card: Solo [ ] Maestro [ ] Visa [ ] Mastercard [ ] (please tick)

Card number ............................................................................................................


Expiry Date ......... / .......... Security Number (on reverse of the card) ...................
Valid From (Maestro / Solo only) .......... / .......... Issue Number .....................
Card Holder's Signature ................................... Date .......................................
[ ] I enclose a cheque / postal order made payable to Huddersfield Community Trust
Please print address and course reference on the back of your cheque.
Total Amount: ....................
If my son / daughter is injured and I cannot be contacted, I hereby give my consent for my son / daughter to receive medical
attention: YES / NO
I agree that The Zone HCT venue are NOT liable for any loss, damage or injury: YES / NO
I agree that The Zone HCT can take photographs for publicy purposes: YES / NO
Please note - once you have returned your application form you will NOT receive confirmation.

SIGNED ......................................................................................................

Mail to:The Zone Huddersfield Community Trust

Off St Andrews Road, Huddersfield, HD1 6PT