REGISTRATION FORM
Player Details
Name
*
First Name
Last Name
Birth Date:
*
Please select a day
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Day
Please select a month
January
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Month
Please select a year
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Year
Age of Player as of January 1st, 2022
*
Preferred Playing Position
*
Previous Club(s) / Experience
*
Parent / Caregiver Information
Primary Contact Details
Name:
*
First Name
Last Name
Email
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Secondary Contact Details
Name
First Name
Last Name
E-mail
Phone Number
Please enter a valid phone number.
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A Friend or colleauge
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Social Media
Football in Schools Program
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