Player Name *

D.O.B (DD/MM/YY) *

Parent/Guardian Name *

Parent/Guardian Email Address *

Parent/Guardian Phone Number *

Emergency Contact Number

Academy Location *

Academy location interested in joining:

Preston U5 - U7 (3G Pitch - Ashton High School, PR2 1SL, Monday - 18:00 - 19:00)

Preston U8-U10 (3G pitch - Ashton High School, PR2 1SL, Monday - 18:00 - 19:00)

Preston U11-14 (3G pitch - Ashton High School, PR2 1SL, Monday - 19:00 - 20:00)

Lancaster City FC Development Squad Trials U14-U16,(Tuesday - 8-9pm, LA1 3JD)

Lancaster City FC Development Squad Trials U9 & U10 (Wednesday - 6-7pm, LA1 3JD)

Lancaster City FC Development Squad Trials U8 Indoor (Friday - 6-7pm, LA1 3JD)

Lancaster City FC Development Squad Trials U11-U13 (Friday - 7-8pm, LA1 3JD)

Bury Town FC Development Squad Trials U8 - U10 (Skyliner Sports Centre 3G IP32 7QB, Monday - 18:00 - 19:00)

Bury Town FC Development Squad Trials U11 - U13 (Skyliner Sports Centre 3G IP32 7QB, Monday 19:00 - 20:00)

Garstang U6 - U10 (Garstang Academy Sports Hall, PR3 1YE, Wednesday - 5.30 - 6.30pm)

Child's Playing Age for 2018/19 Season e.g Under 9

Footballing Experience

Any previous clubs, academies

Does your child have any medical conditions which we need to be aware of?

How did you hear about us?

I would like to hear from Orange Soccer about updates, promotions & exciting things that are happening @ OS HQ. Your information WILL NOT be passed onto any external 3rd party bodies. * *

YES

NO

For more information fill in the form below and we will contact you via phone or email regarding signing up for a taster session.