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Nyali, Mombasa
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0757026229
Address
Nyali, Mombasa
Call Us
0757026229
Home
About us
Shop
REGISTER TO JOIN
Gallery
FAQs
Home
About us
Register
Shop
FAQs
Gallery
TEST FORM WITH PAYSTACK
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About us
Register
Shop
FAQs
Gallery
TEST FORM WITH PAYSTACK
REGISTER HERE
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REGISTER HERE
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SPORTS FIT ACADEMY REGISTRATION AND CONSENT FORM
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Personal Information - Child/Young Person
Your Name
(Required)
First
Last
Your Address
Street Address
Address Line 2
City
ZIP Code
Date of Birth
Day
Day
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Month
Month
1
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Year
Year
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1991
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1978
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1971
1970
1969
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1964
1963
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1961
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1958
1957
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1952
1951
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1948
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1945
1944
1943
1942
1941
1940
1939
1938
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1936
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1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Gender
Male
Female
Are there any activities in which your child can not participate?
Yes
No
If Yes please give details
Personal Information-Parent/Guardian/Carer
Your Name
(Required)
First
Last
Your Phone
(Required)
Email
(Required)
Emergency Contact Information
Name of alternative adult to contact in terms of emergency
(Required)
First
Last
Contact number of alternative adult
(Required)
Relationship to child / young person
Emergency Contact Information
Are there any specific medical conditions requiring medical treatment?
Yes
No
Details of medication required (e.g pills, inhaler)
If Yes, please give details
Are there any other medical conditions or disabilities to be aware of?
Yes
No
If Yes, please give details
Please read carefully
I hereby grant permission for my son/daughter to participate in the activities of Sports Fit Academy.
Yes
No
I confirm to the best of my knowledge that my son/daughter does not suffer from any medical condition other than those listed above.
Yes
No
I consent to my son/daughter travelling by any form of transportation (minibus or motor vehicle driven by a Club Coach or designated driver), to any event in which the Sports Fit Academy is participating.
Yes
No
I understand that the Academy and/or Organizers accept no responsibility for loss, damage or injury caused by or during attendance in any of the Academy organized activities except where such loss, damage or injury can be shown to result directly from the negligence of the Academy and/or the Organizers.
Yes
No
Images
Sports Fit Academy may wish to take photos or videos of the team or individuals partaking in the academy's activities. We adhere to the Football Federation of Kenya (FKF) Guidelines to ensure these are safe and respectful and used solely for the purpose they are intended for, which is promotion and celebration of the activities of Sports Fit Academy. Please indicate if this is acceptable to you:
Yes
No
Signature
Sign here
Safety
All children undertaking any training session(s) or matches that have been organized by the Academy are advised to wear appropriate clothing, footwear and shin guards. Any child attending the football coaching sessions deemed not to be wearing suitable training gear may not be permitted to take part in the day's activities. Sports Fit Academy will provide all other equipment. The academy will strictly adhere to COVID-19/Mpox safety precautions including temperature checks before sporting activities begin.
(Required)
I confirm my Child's Registration
Signature
Print name
Today's date
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
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
Year
Year
2027
2026
2025
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
1923
1922
1921
1920
Declaration of Consent
I give my consent that if an emergency medical situation arises, Sports Fit Academy may act in loco parentis for administration of first aid and/or other medical treatment that in the opinion of a qualified medical practitioner may be necessary.
Yes
No
I also understand that in such circumstances all reasonable steps will be taken. I grant permission for my child to receive first aid care should the need arise.
Yes
No
I hereby grant permission for my child's photo/video to be used on Sports Fit Academy's social media sites (Facebook, Instagram, LinkedIn, WhatsApp, and the Academy's website) for promotion of the activities of Sports Fit Academy
Yes
No
I understand that I will provide transportation to and from the training ground for practice sessions unless otherwise arranged.
Yes
No
I further certify that I have read and completed this form to the best of my ability.
Yes
No
I confirm that I have read, or been made aware of the Academy’s Code of Conduct for parents, coaches and children; Transport policy · Changing-room policy · Policies on photography, videoing, texting and use of social media.
Yes
No
I confirm that my child is aware of the Sports Fit Academy Code of Conduct for children and its anti-bullying policy.
Yes
No
Signature
Print name
Select Programme
Football
Basketball
Football
Price:
Basketball
Price:
Total