BFA Futsal Registration Form (Term 2)

BFA Futsal Registration Form (Term 2)

For boys and girls aged 3 to 12 years old.
Venue - Morris Iemma Indoor Sports Centre

150 Belmore Rd North, Riverwood NSW 2210
Player Name *

First Name Last Name
Player Date of Birth *

Day Month Year
Date
Any medical conditions we need to be aware of? If yes, please provide details below.
Parent/Caregiver Name *

First Name Last Name
Phone Number *
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State

Postcode
Select Your Program

Age group: 3 to 5 Age group: 6 to 12
Payment Instructions
Age group 3 to 5: $250 for term 2
Age group 6 to 12: $280 for term 2

Payment must be made via direct transfer into the following bank account:

Account Name: Brazilian Football Academy
Bank: St George
BSB: 112-879
Account No. 476415615

Ensure that you include the player's name in the reference for the transfer.

PLEASE COMPLETE PAYMENT TRANSFER AND UPLOAD TRANSACTION RECEIPT BELOW OR EMAIL IT TO hi@bfafootball.com.
Upload transaction receipt here

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Cancel of
Please tick boxes below to accept Brazilian Football Academy's terms and conditions for new registrations *

I am aware of my child participating in this football program. I acknowledge that risk of injury is inherent in sports such as football and that from time to time, there may be accidents and falls which may cause serious injury to the participant. I indemnify Gabriel Gomes in person and The Brazilian Football Academy against any claim for damages against them as a result of any injury to my child. I certify that my child is in good health and able to participate in all activities. I agree to notify the coaching staff of any pre-existing medical or psychological conditions. If attention is required for illness or injury, I give my permission to a staff member for such care. The Brazilian Football Academy may use images taken from the BFA Academy Events on the BFA Website. If you do not want your child included in marketing images, please advise the coaching director directly that you do not permit the use of these images.
Signature *

Clear
FOR MORE INFORMATION OR QUESTIONS CONTACT OUR
TECHNICAL DIRECTOR GABRIEL GOMES

Phone: 0430 654 186
Email: gabriel.gomes@bfafootball.com
Should be Empty:

BFA Futsal Registration Form (Term 2)

Venue - Morris Iemma Indoor Sports Centre

Payment Instructions