This registration form requires that JavaScript is enabled in your browser! Please enable JavaScript in your browser, or switch to a compatible web browser, so you can use the registration form. For more information on how to resolve this problem, see Google Help PL Kicks - Gorseinon PLEASE NOTE: Payments are temporarily offline, please revisit later to complete your booking Tuesdays5.00pm-6.00pm (Age 8-11) (Year 4, 5 & 6)6.00pm-7.00pm (Age 12-14) (Year 7, 8 & 9)7.00pm-8.00pm (Age 15-16) (Year 10 & 111)Sessions will commence on 10th September 2024 and run weekly (except for school half terms) until 8th July 2025.Due to the Christmas Break, there will be no further sessions until week commencing 13th January. Hope you all have a lovely Christmas and a Happy new year!Before you submit the form, could you please check the child's name is correct. If you use AutoFill when completing the form it might change details elsewhere on the form. Location Evolve Gorseinon (Indoor Barn) Pontardulais Rd, Gorseinon Swansea SA4 4FE Get Directions Contact Details Craig Richards 07884655128 [email protected] Online Booking Form Booking Options Select Tuesdays: 5.00pm-6.00pm (Age 8-11) Year 4, 5 & 6 Tuesdays: 6.00pm-7.00pm (Age 12-14) Year 7, 8, & 9) Tuesdays: 7.00pm-8.00pm (Age 15-16) Year 10 & 11 * Parent / Guardian Information Parent/Guardian Full Name * Parent/Guardian Contact Number * Parent/Guardian Email Address * Address 1 * Town * County * Postcode * Second Emergency Contact Name * Second Emergency Contact Number * Child Information Child's First Name * Child's Last Name * Age 7 8 9 10 11 12 13 14 15 16 17 18 * Date of birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 * Ethnicity White - Welsh/English/Scottish/Northern Irish/British White - Irish White - Eastern European White - Other Black/African/Caribbean/Black British - African Black/African/Caribbean/Black British - Caribbean Black/African/Caribbean/Black British - Other Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Chinese Asian/Asian British - Bangladeshi Asian/Asian British - Other Mixed/multiple ethnic groups - White and Asian Mixed/multiple ethnic groups - White and Black African Mixed/multiple ethnic groups - White and Black Caribbean Mixed/multiple ethnic groups - Other Other ethnic group - Other * Gender Male Female Prefer not to say Other * Disability Yes No * Does your child suffer from any medical conditions/allergies that the Foundation staff should be aware of, including any current medication? Yes No * Please use the space below to state if your child requires any extra support at the session and how we could do this: What school/college does your child attend? * What year group? Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Sixth Form / College Not in education * Does your child play for a football club? Yes No * Consent I give permission for my child to leave the session without parent/guardian supervision. I consent to Swansea City AFC Foundation / Swansea City AFC taking and using photographs / video of my child for the purposes of publicising the Foundation's projects or for use as part of a report to funders. Tick the box if you want your details to be added to the mailing list to receive marketing information from the Swansea City AFC/Swansea City AFC Foundation such as information about tickets, merchandise, future soccer camps and other general news. I consent to Swansea City AFC Foundations Privacy Notice & Code of Conduct * I accept the Terms and Conditions and Privacy Policy of Participant UK Ltd. (Participant UK Ltd provide the booking and payment platform to this organisation). * Once registered, you will receive a confirmation email with further information (might go to junk folder).Please Note: In the event of a player appearance, Swansea City AFC are not liable for any merchandise that is signed without parent permission.The Swans Foundation or associated 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. Participants are required to take responsibility for their own belongings, any loss or damage of property will not be covered by the Swans Foundation. × Off
