Wednesday 22 January 2025 | 3pm-5pm

Parent / Guardian Details

First Name

Last Name

Mobile

Street Address

City/Suburb

State

Zip/Postcode

Participant Details

First Name

Last Name

Address same as Parent / Guardian

Street Address

City/Suburb

State

Zip/Postcode

Emergency Contact (if different from above)

Please provide name and mobile number.

Gender

Medical Information

Please provide any relevant medical details. If this is not applicable please enter N/A.

Age

Favourite Team and Player

Additional Information

Photography Consent

I acknowledge and consent to photographs and electronic images being taken of registrant during their participation in the program. I, as the parent/guardian of registrant acknowledge and agree that such photographs and electronic images are owned by Adelaide Football Club and that the club may use the photographs for promotional or other purposes without my further consent being necessary.

Membership & Correspondence Consent

By registering for this event, I acknowledge that the participant will receive a 4-Game Flexi membership with the Adelaide Football Club. This membership will be sent via email following attendance at the registered event. By signing up to receive a free membership, you agree to join the Adelaide Football Club as a Member and consent to receiving promotional material from the Adelaide Football Club. You can update your email preferences at any time.

I consent.

Payment Summary