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Social Football – Per Term

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"*" indicates required fields

Team You Are Registering For*

Name of Player*

First Last

Player's Date of Birth*

Passport Style Photo*

REQUIRED. Please upload a clear/good quality headshot photo (passport style) to be used for league registration

Drop files here or

Accepted file types: jpg, gif, png, jpeg, heic, Max. file size: 20 MB, Max. files: 1.

Player Subs

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Payment Type

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Sibling Discount (single)

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Sibling Discount (split)

Home Address*

Street Address Address Line 2 City Post Code

Name of School*

-

Name of Primary Parent/Guardian*

First Last

Parent/Guardian Tel Number (Primary)*

Parent/Guardian Email (Primary)*

-

Name of Secondary Parent/Guardian

First Last

Parent/Guardian Tel Number (Secondary)

Parent/Guardian Email (Secondary)

-

Emergency Contact Name*

First Last

Relationship to Player*

Emergency Contact Tel Number*

-

Medical Conditions

Please detail any medical information that we need to be aware of.

-

Player Conduct*

I have read and agree to the Player Code of Conduct

Parent Conduct*

I have read and agree to the Parent Code of Conduct

First Aid

In the event of an injury to the player, I consent to basic first aid being administered by qualified coaches and managers

Photos

I consent to match/training photos of the player being used for marketing/promotional purposes

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SKU: SOCIAL-TERM Category: Membership Fees