2022 Phoenix Cup - Player Expression of Interest

2022 Phoenix Cup

Player Expression of Interest
Name:*

First NameLast Name
Gender:*

MaleFemaleOther
Date of birth*

DayMonthYear
Date
Email*
example@example.com
Phone Number:*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent name*

First NameLast Name
Parent phone number*

Area CodePhone Number
Competition Format

Provided that the number of teams allows us to, the Phoenix Cup will have two divisions to choose from.

Division 1 - Competitive league

Division 2 - Social league
Please choose the division you would like to play for:*

Division 1Division 2
Do you/the participant identify as having an Integration difficulty?*

Acquired Brain InjuryAutism Spectrum DisorderDevelopmental DelayHearing ImpairmentIntellectual DisabilitySensory SensitivityVision ImpairmentMental Health ConditionPhysical DisabilityOther
Does the participant have a preferred method of communication?
verbal, sign etc
To maximise participation and enjoyment of the event, does the participant require support?*

YesNo
Will a support worker or other assistant be in attendance?*
Do you/the participant currently participate in soccer and or other sports?*

YesNo
Which sport and club?*
Is there anything else you would like to share with us?
Thank you!
Should be Empty: