New Online Client form

Name *

Date of birth: *

Email *

Phone number: *

What do you hope to achieve by training with Toni Cronk Goal Keeping? *

What are 3 areas of your goal keeping you think you are good at?

What are 3 areas of your goal keeping you think you need to improve?

Long Term Goals (4-10 Years)?

Short Term Goals (now-4 years)

Any pre existing injuries or illnesses that I need to know about? (please specify if yes)

Have you read the terms and conditions below? *

Yes

Terms and Conditions: 1) The full price of the course must be paid for prior to course commencement to ensure registration and place in the course; 2) A cancellation policy applies as follows: 21 days notice or more: full refund, 15-20 days notice: loss of 25% of course fee, 2-14 days notice: loss of 50% of course fee, 2-0 days notice: no refund. Toni Cronk will use discretion in addressing individual circumstances; 3) Toni Cronk reserves the right to cancel a course if there are insufficient numbers; 4) By registering you agree that there is the possibility of injury whilst participating in sport and therefore consent to first aid being carried out in the event of an injury; 5) Toni Cronk accepts no responsibility for loss or damage whether to person or property in connection with this clinic. 6) Toni Cronk may take photos during clinics for use on the website, social media, in marketing material, and for media opportunities.

Any other comments?

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