FFC MESSY DRIBBLERS 2025
TERM 4 Registration Form Term Starts from 12 October- please note multiple children cannot be registered at the same time. Please complete form separately.
Email
*
example@example.com
Child's Name
*
First Name
Middle Name
Last Name
Child’s age
*
Child’s year of birth
*
Example 2018
Please select
*
Female
Male
Address
*
Street Address
Street Address Line 2
City
State
Postal Code
Child's current school / day care
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Emergency Contact Information
Name of Emergency Contact
*
First Name
Last Name
Mobile Contact Number
*
Relation to child
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Parental/Guardian Consent
Medical / Injury information
*
Please disclose all relevant medical conditions and injury information that may affect a players safety and involvement in physical activity. Please note our programs involve conditioning exercises that are very strenuous for some participants.
Terms & Conditions please read and confirm
*
I hereby declare that to my full knowledge and capacity, I give my full permission to let my child be treated by qualified medical physician in any circumstance that such attendance be so required to perform all or any immediate medical check-up or treatment. I am fully aware that this sport activity may cause accidental injury to registered players. I likewise assume any and all possible risk that may cause injury, illness, or death arising to such activity. I hereby declare that I waive my right to pursue any and all claims against Football Fitness Coaching and the coaches associated with this program should in any case that the accident, injury or illness occurs in the course of any activity held by them. COVID 19 - I understand that FFC Messy Dribblers staff and coordinators will continue to follow government regulations in regard to Covid safety measures. Parents must comply with current Covid regulations while attending the program. If classes are cancelled due to Covid 19 I understand that a refund will not be provided but a full credit of the fees will be provided. The credit will be valid for two years. ABSENCES - I understand that if my child is absent from a class that the missed class can not be caught up at a later date. Refunds/credits are not provided for an absence. Absences include general illness. WET WEATHER - I understand that Messy Dribblers program will run in some wet weather. If a class is cancelled due to weather, FFC Messy Dribblers will organise a make up session or provide a credit for a future program, refunds will not be applied to wet weather cancellation. Classes that are cancelled will be done so no later than 45 minutes prior to the start of the session. POOR BEHAVIOUR - I understand that FFC Messy Dribblers will not tolerate any bullying or constant disruptive behaviour and that any of these instances may result in children being removed from the remainder of the program with no refund. I understand that I have a responsibility to help coaching staff maintain a fun learning environment by monitoring my childs behaviour throughout sessions.
FFC Behaviour Management Process - to ensure maximum enjoyment of our program for all our young participants, the following behaviour management procedures will be followed by coaching staff in the result of constant disruptive behaviour; 1. Coach discussion with child to highlight why the behaviour is disruptive and not acceptable. 2. Coach will ask the child to take a time out on the side of the playing area next to the coach. 3. Coach will ask the child to take a time out sitting with their parent/guardian on the side of the playing area. 4. Child may be asked to leave the remainder of the session and can return to the session the following week.
FFC capture photos and videos during our programs which are used for marketing purposes. Do you provide consent for your child to be in any pictures/videos
*
Yes
No -please keep my child out of any photos/videos
Name
*
First Name
Last Name
Programs (please select below)
*
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8.00AM TERM 4 SUNDAY Messy Dribblers 3-4 yrs group
$
165.00
AUD
3-4 yrs Messy Dribblers Program Term 4 starting Sunday 12 October. 8-week program. *Please note no class on 19 October. Class time 8am location Curlew Park Sandgate. Ages 3-4 years, 45minute sessions. Price includes presentation gift.
8.00AM TERM 4 SUNDAY Messy Dribblers 4-5 yrs group
$
165.00
AUD
4-5yrs Messy Dribblers Program Term 4 starting Sunday 12 October. 8-week program. *Please note no class on 19 October. Class time 8am location Curlew Park Sandgate. Ages 4-5 years group, price includes presentation gift.
8.00AM TERM 4 SUNDAY Messy Dribblers 5-6 yrs group
$
165.00
AUD
5-6yrs Messy Dribblers Program Term 4 starting Sunday 12 October. 8-week program. *Please note no class on 19 October. Class time 8am location Curlew Park Sandgate. Ages 5-6 years group, price includes presentation gift.
8.00AM TERM 4 SUNDAY Messy Dribblers 6-8 yrs group
$
165.00
AUD
6-8 yrs Messy Dribblers Program Term 4 starting Sunday 12 October . 8 week program. *Please note no class on 19 October. Class time 8.30am location Curlew Park Sandgate. Ages 6-8 years group, price includes presentation gift.
MONDAY AFTERNOON Messy Dribblers 4-6 years EXPRESSION OF INTEREST
$
Free
AUD
This is an expression of interest for Term 3 MONDAY 4pm to 5pm. Curlew Park. 6 week program. More info and a registration link will be sent once the program is confirmed.
Trial Class ONLY 3-5 yrs Contact Director First
$
Free
AUD
3-5 years ONLY. Please ONLY select if you have confirmation from Course Director to attend as a trial. All players attending a trial must have permission to do so by Course Director and complete registration form
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Subtotal
$
0.00
AUD
Tax
$
0.00
AUD
Total
$
0.00
AUD
Payment Methods
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Signature of Parent / Guardian
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