ASSOCIATION FOOTBALL CLUB Full Members of the Football Association Members of: The League, Mid Lancashire League, Central Lancashire Junior League, & Mid Lancashire Colts Junior League

Chairman & General Secretary: Paul Sergeant, 108 Moss Lane, Hesketh Bank, Preston PR4 6AD. Telephone: 01772 814009, Mobile: 07713158393. Email: [email protected]

SUMMER SOCCER SCHOOL Monday 6th to Friday 10th AUGUST on the 3G Pitch @ HBAFC

FUN FOOTBALL FOR BOTH BOYS & GIRLS AGES 5-12 YEAR OLDS All Coaches are fully qualified by the F.A, hold First Aid Certificates and are CRB checked

10am – 3pm @ £40 per Child for the full 5 Days or £10 a day Places are limited and will be allocated on a 1st come 1st served basis

PLEASE BRING: Packed lunch for each day ~ plenty to drink AND appropriate clothing for the weather

APPLICATION FORM

Name………………………………………………………………………………………. AGE……… DOB………………

Address……………………………………………………………………………………….…………………………………..

Mobile……………………………………..Email……………………………………………………………………………..

Medical Conditions…………………………………………………………………………………………………………..

My Child will attend the Full Week @ £40 or these days @ £10 a day Mon Tue Wed Thur Fri (Please circle)

I give consent for my child to take part in the activity and consent to emergency treatment as necessary. I accept that the organisers and their employees are not under any liability whatsoever in respect of injury, loss or damage whilst on the course, other than imposed by the law. I have read and accept the above conditions and confirm that I am legally entitled to give this consent.

Signed Parent/Guardian…………………………………………………………………..Date…………………

ALL FORMS WITH PAYMENT, CASH OR CHEQUE, MUST BE RETURNED TO: PAUL SERGEANT, 108 MOSS LANE, HESKETH BANK PR4 6AD If paying by cheque please make payable to: Hesketh Bank AFC YOU CAN ALSO PAY BY BANK TRANSFER & EMAIL THE FORM to: [email protected] For Bank Transfer: HSBC Sort Code: 40-24-14 Account No: 01099876 ANY QUEIRIES PLEASE CONTACT PAUL SERGEANT ~ Mobile: 07713158393