Mavericks Booking Form 1. Activity Type *Activity: Please select an activity 2 Day Netball Camps 3 Day Netball Camps 5 Day Netball Camps Netball Masterclasses Coaching Workshops *Date: Please select a date *Date: Please select a date Bedford Academy, Mile Road, Bedford, MK42 9TR : Weds 29 - Fri 31 May 2019, 10.00 am - 3.00 pm *Date: Please select a date NO 5 DAY CAMPS AVAILABLE AT THIS TIME *Date: Please select a date *Date: Please select a date TBC *Date: Please select a date 2. Player Information *Full name: *Date of Birth: Day: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month: Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec Year: 2013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914191319121911 *Address: *Postcode: *Email: *Academy Name: *Coach Name: *Club Name: *School Name: *Doctor Name: *Doctors Details: *Relevant Medical Details: 3. Emergency Contact Details Contact 1 *Title: *Full Name: *Relation: *Mobile No: *Telephone No: Contact 2 *Title: *Full Name: *Relation: *Mobile No: *Telephone No: 4. Payment I have read and agree to the terms and conditions: X Terms & Conditions Places will be confirmed by email, upon receipt of a completed booking form together with full payment. If a participant withdraws after being accepted onto a camp, Mavericks Netball reserves the right to withhold the full camp fee. In the event the camp being cancelled a full refund will be issued. Mavericks Netball may take photographs and/or video of participants during camp activities. These images may be used for publicity purposes on our website or in printed publications. It should be noted that at no time will the participants name be directly associated with any picture or video footage. If a participant has strong views about not having their image publicised, they will need to make this clear at the outset. All participants’ personal property is their own responsibility. Mavericks Netball takes not responsibility for loss or damage for these items. Food and drink is not included in the camp cost. Players are expected to bring packed lunches and drinks as there may not be opportunity to purchase these at the venue. The Coaching Staff reserve the right to remove anyone being disruptive or not adhering to the rules of the Camp. All participants are covered by Public Liability insurance whilst on the Mavericks Netball Camp. However, Mavericks Netball cannot be held responsible for any act, omission or loss or damage unless proven to be caused by Mavericks Netball’s negligence. In the event of participant injury/illness, all reasonable steps will be taken to contact the emergency contact(s) named on the booking form and the injury/illness will be dealt with appropriately. In the event that the emergency contact(s) cannot be contacted, consent is given to the Coaching Staff to act on their behalf. All participants must be registered at the start of the day and must register out before they leave the Camp each day. Pay Via Cheque: Pay Via