Song Khran Camp
Player Registration

 Please complete this form to register your child


Cost :

1 Week THB   6,500

Book :

7th to 11th April 2014
  2 Weeks THB   11,000   14th to 18th April 2014
Family Name :  

Given Name :  

Date of Birth :  

Sex : 

Boy -  Girl

School :  

Class :  

Fathers Name :     
Mobile Number :  

eMail :  

Mothers Name :     
Mobile Number :  

eMail :  

Home Phone :  

Other Contact :  

Emergency Contact Name :     
Emergency Contact Number :  



Parent / Guardian Declaration

I have read and accepted the Terms & Conditions on behalf of the above applicant for a place on iPlay Soccer Camp.


This declaration must be completed and signed by a parent/guardian of the participating child and returned to iPlay Sports before the start of the soccer camp. The participant will not be permitted to start the soccer camp until this form is fully completed and returned. If the answer to questions 1-5 is YES or NO to question 6, then the child will not be permitted to start the soccer camp, unless you obtain and forward to us a note from the child's medical practitioner confirming that the child is fit and able to undertake the soccer camp activities.

Has your child ever had a heart condition, or suffered any pains in the chest when doing physical activity? Yes   No
Does your child suffer diabetes or any other blood problem? Yes   No
Has the child any joint, bone or muscle problem that could worsen with exercise? Yes   No
Has the child ever suffered from any pain, distress or medical condition in the past caused as a result of physical activity? Yes   No
Do you know of any medical or health reason as to why the child should not take part in the soccer camp or which might affect the child's health and well being during the soccer camp? Yes   No
If the child is asthmatic but able to administer their own inhaler, has the child received medical clearance to participate in our course? Yes   No
Does your child have any other allergies or medical conditions we should be aware of? Yes   No

I hereby confirm that in the unlikely event of the child requiring first aid or emergency treatment iPlay Sports Co., Ltd are duly authorized to provide first aid and arrange any necessary emergency medical treatment. I confirm that I have read, understood and answered all questions honestly and to the best of my belief. I understand that the participation of the child in the soccer camps will involve physical activity and exertion. In the event that I become aware of any change in the health of the child I shall inform iPlay Sports Co., Ltd.

Parents Signature :