COURSE SCHEDULED DATES

SESSION 1 - Course Module 1 - Introduction/Safeguarding Children Workshop*
DATE:    Wednesday 23 May 2012
TIME:    7pm - 9pm

SESSION 2 - Course Module 2
DATE:    Wednesday 6 June 2012
TIME:    7pm - 9pm

SESSION 3 - Course Module 2
DATE:    Saturday 9 June 2012
TIME:    9.00am - 4pm

SESSION 4 - Course Module 2
DATE:    Sunday 10 June 2012
TIME:    9.00am - 4pm

SESSION 5 - Course Module 3 - Examinations
DATE:    Wednesday 13 June 2012
TIME:    7pm - 9pm

SESSION 6 - Post Course Review
DATE:    Wednesday 20 June 2012
TIME:    7pm - 9pm


Course Fees:

14 - 15 Years of Age:
£85.00 (This also includes the cost of FA Safeguarding Children at £12.00)

16 - 17 Years of Age
£95.00  (This also includes the cost of FA Safeguarding Children at £21.00)

18+
£110.00 (This also includes the cost of FA Safeguarding Children at £21.00 and FA CRB at £15.30)


HAMPSHIRE FA
FOOTBALL EDUCATION BOOKING FORM
LEARNING AGREEMENT

By Ticking the box below confirms I understand:

Hampshire FA reserves the right to increase or decrease the course fee at its discretion

I am fully aware that my chosen course may be one which includes the FA Child Protection three hour Workshop, which discusses some sensitive hypothetical issues and some real issues regarding child abuse in its various forms. If I am under the age of 16 I will not attend the FA Child Protection workshop but instead will receive the Child Protection Distance Learning guide*.

I am fully aware I am the only participant who can attend the FA Safeguarding Children Workshop, I understand that no other person may attend in my place should I be unable to attend.

The following cancellation fees will be what the candidate will receive in a credit note to use for Hampshire FA courses only:

75% return if 2 months notice given

50% return if 1 month notice given

25% return if less than one month given

No return if less than 7 days given

I understand that I must attend ALL the scheduled course dates as outlined above.

I will respect the course tutor, course venue and the other candidates and their points of view and I understand that if my behaviour, language or conduct is deemed unacceptable, offensive or harmful for any reason, the Hampshire FA and the venues reserves the right to exclude me for continuing on my chosen course and if necessary, future courses.

The Hampshire FA does not accept responsibility for the loss, or damage to, candidate property or for personal injury however caused and that I will ensure that I am protected with my own personal insurance cover.

I understand that I am responsible for providing my own Refreshments during the course scheduled dates.
 
I confirm that I understand the above statements and their implications and that the information I have provided on this form is correct to the very best of my knowledge.

If you have any Criminal Convictions then can you please put details on a separate piece of paper.

If you are on General Suspension you cannot attend the course until you have been cleared.