Adam Virgo Academy - Welcome Pack (Membership, Kit and Holiday Camp Discount)

This form is to be completed by the legal carer of the young person being enrolled in The Adam Virgo Academy. It is a requirement that this form is completed and verified by the legal carer.

Legal carers are responsible for informing The Adam Virgo Academy Coordinator of any changes as they occur.  Please email info@adamvirgoacademy.com

All club sessions involving junior members are run under the guidance of coaches qualified to the appropriate level 1 - level 3 UEFA B and A qualification.

All information provided will be held under a secure SSL certificate. Our coaches need to know these details in order to meet the specific needs of your child.


Please note: All children are required to bring plenty to drink and attend the training session in their Adam Virgo Academy kit. Please could they also wear correct footwear e.g. astro boots or molded football boots AND shin pads.

We ask kindly for all attendees to please respect the facilities and ask parents to park in the appropriate spaces provided by the venues.



Wednesday

Waterhall Playing Fields (Brighton Rugby Club), Waterhall Road, Brighton, East Sussex, BN1 8YR

16:30 - 18:00

Age: 5-19


Thursday

Steyning Town Community Football Club, Steyning, BN44 3RX

16:00 - 17:30

Ages 5-12


Friday

Hassocks Sports Centre, Dale Ave, Keymer, Hassocks BN6 8LP

16:30 - 18:00

Ages 8-16

Dates and Times

 

Online Registration Form

Price category
 *
Child's First name
 *
Child's Last name
 *
Child's Age
 *
Child's Date of birth
   *
Parent/Guardian Full Name
 *
Relationship to Child
 *
Parent/Guardian Email
 *
Parent/Guardian Mobile
 *
How did you hear about us?
 *
Please select your child's preferred kit size
 *
CONSENT (please read carefully)
 *
I will inform the coaches of any important changes to my child's health, medication or needs and also of any changes to our address or phone numbers given.
 *
In the event of illness, having parental responsibility for the above named child, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication.
 *
I agree to my son/daughter taking part in the activities of the club.
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I confirm to the best of my knowledge that my son/daughter does not suffer from any medical condition other than those listed above, and accept his/her involvement in any activity the coaches put on, and permit my child to participate at their own risk.
 *
I understand that the Club or Organisers accept no responsibility for loss, damage or injury caused by or during attendance on any of the clubs organised activities except where such loss, damage or injury can be shown to result directly from the negligence of the Club or the Organisers.
 *
Please tick to confirm that you are happy to be contacted by the academy and continue receiving correspondence from the AV Academy via email, phone or SMS. * Please note all Data collected on the consent form will be held via a secure HTTPS connection which the academy has purchased.
 *
Terms and Conditions
Promotional code
 
 *

Once you have received confirmation of membership, please book the relevant session.

Location

Contact Details

Contact us

For more information or to book please call:

or email: