WESPA 1:1 PERFORMANCE TRAINING MEMBERSHIP

SECTION 1 - ABOUT THE ATHLETE/MEMBER
Athlete Name Athlete Name * First Last
Please tell us the name of the athlete.
Athlete's Date of Birth Athlete's Date of Birth * / DD / MM YYYY

Please tell us the athlete's's date of birth.
Athlete's Name of School *

Please tell us the name of the member's school.
Athlete's Primary/Preferred Sport(s) *

Please tell us the athlete's primary/preferred sport(s). Please write NONE if the athlete doesn't have a primary/preferred sport.
Athlete's Sporting Achievements *

Please select ONE of the drop-down options that best fits the member's highest representative achievement to date.
Athlete Medical Conditions *

Please tell us of any athlete medical conditions we should be aware of. If no medical conditions then please type NONE.
SECTION 2 - MEMBERSHIP
1:1 Memberships *

Please select your preferred 1:1 coaching membership and note that ALL 1:1 memberships include the weekly drop-in sessions.
SECTION 3 - PARENT(S) INFORMATION
Parent 1 Name Parent 1 Name * First Last
Please tell us your/parent name.
Parent 2 Name Parent 2 Name First Last
If you would like to give us a Parent 2 name then please type it here. This is an optional field and not a requirement.
Parent 1 Email *

Please tell us your email address for all future communications.
Parent 2 Email

If you would like Parent 2 to also receive WESPA emails then please type an email address into this field. This is an optional field and not a requirement.
Parent Contact Telephone Number *

Please tell us your best contact telephone number for emergencies.
Parent 2 Contact Telephone Number

If you would like us to have a Parent 2 contact telephone number for emergencies then please type into this field. This is an optional field and not a requirement.
Address Address *
Street Address Address Line 2 City County Postcode Country
We may film and or take photographs during sessions and if so, do we have your permission to use the member's image(s) for official WESPA promotional material? *

Please select one of the drop-down options.
Spam Protection. Please answer this simple question.
In the number 63829, what is the 1st digit?
£0

Total

WESPA 1:1 PERFORMANCE TRAINING MEMBERSHIP

WESPA 1:1 PERFORMANCE TRAINING MEMBERSHIP

SECTION 1 - ABOUT THE ATHLETE/MEMBER

SECTION 2 - MEMBERSHIP

SECTION 3 - PARENT(S) INFORMATION

£0

Total

£`0`