BOOK YOUR FREE TRIAL

Please complete the details below and a member of our team will contact you to confirm your free trial session.

Alternately you can contact us by email or WhatsApp:

(W) +27 60 894 1038

(e) info@coerver.co.za

SELECT YOUR REGION

Please select your Region

PARENT'S DETAILS

First Name

Last Name

Phone

(###)

###

####

PLAYER'S DETAILS

First Name

Last Name

Date of birth

YYYY

Current School

Current Grade

MEDICAL DETAILS

Medical Aid Society

If you do not currently make use of a Medical Aid please type PRIVATE.

Medical Aid Number

Medical Aid Main Member

Medical History

Is there any medical condition/history that we need to be aware of?

INDEMNITY & CONSENT

Please read carefully and select the relevant option

I hereby consent to Coerver® South Africa recording, retaining and reproducing my child’s image and voice by way of photographs, sound recordings and video for the purpose of communicating same on requisite closed groups which I have opted into. I further agree to the condition that, while every precaution will be taken for the safety and welfare of my child and for the care of his/her possessions, I will hold blameless and indemnify all persons, Coerver® South Africa and all other organisations associated with the activity, should any prejudice, loss, damage, illness or injury occur to my child during the above activity. This includes an indemnity against recovery of costs resulting from damage, loss and/or medical conditions or hospitalisation, unless such loss is caused by the negligence, wilfulness or deliberate act of Coerver® South Africa or one or more of its employees. I furthermore appoint the Coerver® South Africa staff supervising the activity to act in loco parentis in respect of my child should the need therefore arise.

BOOK YOUR FREE TRIAL

The World’s #1 Soccer Skills Teaching Method