Membership

If you are interested in becoming a KickStart Member, please complete the below application form.

There will be a discount for families with more than one Student/Toddler Member:

  • 2nd  Junior Member – 10% discount;
  • 3rd Junior Member – 15% discount;
  • 4th  junior member – 20% discount.

You will also be asked to sign a liability waiver and a code of ethics.

We will contact you as soon as possible following your submission of the below form.
You may also download for offline submission – Kickstart Membership Form-2015

Camp Registration Form
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  • Camper Details
    2
  • Name of Camper*full name
    3
  • Date of Birth of Camper*Format MM/DD/YYYY click on the calendar to the right to set birth date
    4
  • Does your child / ward have any allergies or medical conditions?*
    Yes
    No
    5
  • If yes please list below:*(Allergies / Medical Conditions)
    6
  • Parent/Guardian Details
    7
  • Name of Parent / Guardian*full name
    8
  • Relationship to Member*
    9
  • Address*
    10
  • Email*
    11
  • Telephone*
    12
  • Mobile*
    13
  • Occupation*
    14
  • Employer*
    15
  • Parent/Guardian Details
    16
  • If you wish to add a second parent/guardian to the application, please complete the section below.
    17
  • Name of Parent / Guardian*full name
    18
  • Relationship to Member*
    19
  • Address*
    20
  • Email*
    21
  • Telephone*
    22
  • Mobile*
    23
  • Occupation*
    24
  • Employer*
    25
  • In case of emergency
    26
  • Emergency Contact Name*full name
    27
  • Emergency Contact Telephone Number*
    28
  • Weekly Attendance*
    Weekly ($150)
    29
  • Daily*$35/day
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
    30
  • Lunch*$10/day
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
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  • Waiver
    32
  • INDIVIDUAL PARENTAL WAIVER - RELEASE OF LIABILITY & INDEMNIFICATION By participation at KickStart Football Club Inc.’s (“KickStart”) football and tennis programs and by payment of the fees as confirmation, a player and guardian agrees to understand and accept the following disclaimer: 1. To release KickStart Football Club Inc. from all risks of personal injury or personal property damage which might be associated with participation and involvement in these programs. I further voluntarily remise, release and forever discharge the Directors of KickStart, its successors, assigns, officers and agents from any and all injuries, losses or damages of any kind whatsoever suffered by the player as a result of the voluntary use and participation in any facilities and activities provided through KickStart. I hereby certify that the player’s physical condition is at a sufficient level to enable them to use the participate in club activities safely. We agree to follow all instructions, rules and regulations of KickStart regarding use of any facilities while engaged in KickStart’s activities. 2. To understand that there are certain inherent risks and hazards involved in participating in athletic events that may result in injury or death to me or my child including, but not limited to those hazards associated with weather and playing conditions, equipment and other participants. 3. Further, in consideration of participation in the Club, we agree on behalf of myself and the player and my heirs and anyone else acting on my behalf to release, indemnify, and hold harmless, and covenant not to sue, KickStart and all of its members and/or agents, from all liability for any personal injury or personal property damage the player might sustain during practice, other workouts, or contests, whether supervised or on their own, and whether attributable to negligence, gross negligence, or recklessness on the part of such persons or entities. BY MY SIGNATURE, I ACKNOWLEDGE THAT I HAVE READ AND THAT I UNDERSTAND EACH AND EVERY ONE OF THE PROVISIONS IN THIS WAIVER, RELEASE OF LIABILITY:
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  • Signature of Parent / Guardian*
    34
  • Payment
    35
  • Payment Options*
    Online Transfer
    Cash / Cheque
    36
  • Payments can be made by Electronic Online Transfer in advance to the following bank details: CIBC FirstCaribbean International Bank BRANCH: Wildey, St. Michael (127) ACCT NAME: Kickstart FC Inc. ACCT No.: 1001095258 Swift Code: FCIBBBBB Payment by cash or cheque can only be made on Mondays at the club between 8:00 a.m. or 10:00 a.m.
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    2016 youth football results can be found here. Congrats to the U9s for winning the 2016 season and to the U13s for taking the 2016 Barbados Cup!

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