2012_application_form_leaflet_pdf.pdf | |
File Size: | 359 kb |
File Type: |
Ainm/Name
____________________________________________
Seoladh/ Address
____________________________________________
Fón / Phone
____________________________________________
Scoil/ School
____________________________________________
Dáta Breithe/ D.O.B.
____________________________________________
Next of Kin (name and contact No.)
____________________________________________
Have you any special medical requirements?
____________________________________________
Are you enrolled as a member of any football club?
____________________________________________
Do you allow the organisers to take photographs of your child during the summer scheme?
____________________________________________
Please return registration form, with payment to Ciara Nic Aodha
72 Faughiletra Rd
Baile an Chláir
Iúr Cinn Trá
BT35 8SH
Make cheques payable to
Coláiste Shliabh gCuilinn