Hotshots Enrollment Form ; 0487 438 348 admin@tems.net.au 110 Old McMillans Rd, Coconut Grove, NT 0822 www.faceback.com/TopEndMultiSports PARENT/CARER DETAILSFirst Name*Surname*Postal Address*Suburb*P/C*Email* Mobile Number*Home Phone No.*YOUR CHILDREN’S DETAILSCHILD #1Child 1 Name*Child 1 Surname*Child 1 Gender*Select GenderMaleFemaleChild 1 Medical Considerations*Date of Birth*CHILD #2Child 2 Name*Child 2 Surname*Child 2 Gender*Select GenderMaleFemaleChild 2 Medical Considerations*Date of Birth*CHILD #3Child 2 Name*Child 2 Surname*Child 2 Gender*Select GenderMaleFemaleChild 2 Medical Considerations*Date of Birth*PREFERRED DAYSCHILD #1Child 1 Preferred Days*Child 1 Preferred Times*Preferred TimesAMPMCHILD #1Child 2 Preferred Days*Child 2 Preferred Times*Preferred TimesAMPMCHILD #3Child 2 Preferred Days*Child 2 Preferred Times*Preferred TimesAMPMABILITIESAbilities* Never Played Just Learning Can Hit Ball Over Net Can Serve Can Rally More info*CONSENT FORMAs Parent/Carer of the above child/ren, I give my consent that he/she participates in the TEMS Soccer Program. I authorise the staff to administer any first aid that may be required in the event of any illness or accident occurring. I agree to the delegation of authority to the staff involved and agree to pay all medical expenses incurred on behalf of the above child/ren.Agree to TEMS* I HAVE READ AND AGREE TO ABIDE BY ALL MAKE-UP LESSON AND PAYMENT POLICIES OF TEMS Name of person making consent*PERMISSION TO USE PHOTOSI grant permission to TEMS to use images of:Parent's Name*Children's name*Such use includes the display, distributions, publications, transmissions or otherwise use of photographs, images and/or videos taken for use in materials that include but may not be limited to, printed materials such as Brochures, Newsletters, Videos and digital images used on TEMS’ website and other Social Media pages, such as Facebook and Instagram.Use of PhotosI grant permission for the use of photos of myself and my children to be usedI deny permission for the use of photos of myself and my children to be used**Please notify TEMS in writing if you would like to withdraw your permission for the use of images.Read Terms of Site* I have read and understood the terms of this site. CAPTCHA
