Bryst FA | KIX4KIDS – My WordPress

Emergency & Medical Contact Information
EMERGENCY CONTACT
In an emergency, when parents cannot be reached, please contact:
Primary Emergency Contact Name*
First Last
Primary Emergency Contact Relationship to Player*
Primary Emergency Contact Phone Number*
Secondary Emergency Contact Name
First Last
Secondary Emergency Contact Relationship to Player
Secondary Emergency Contact Phone Number
MEDICAL HISTORY
If the answer to any of the following questions (below), is yes, please describe the problem and its implications for proper first aid treatment within the registration.
Does the player have any allergies that we need to be aware of?*
- Yes
- No
Please list all the allergies below*
Does the player have any other medical conditions that we need to be aware of?*
- Yes
- No
Please list all the medical conditions that we need to be aware of in the text box below.*

Registration Fee & Payment Options
The program runs on Mondays from Aug 10, 2020 to Oct 26, 2020 at 6:15pm to 7:15pm.
- 10-weeks: $295 + HST
- 8-weeks $245 + HST
- 6-weeks $200 + HST
* Exclusion dates Mon Sept 7 & Oct 12

Available Payment Options are:
- Credit Card: please call the office and provide your credit card information.
- Interac e-Transfer: please e-transfer the total amount including HST to [email protected]
Please select a sessions package*
- 10-Weeks for $295 + HST
- 8-Weeks for $245 + HST
- 6-Weeks for $200 + HST
Please select a payment method*
- Credit Card
- Interac e-Transfer
Please call the Bryst Football Academy and provide your credit card information.
Please e-transfer the total amount including HST to [email protected]

Participant Information