Expression of Interest
Elite F.C Parent and Player Info
Email
*
example@example.com
Child Full Name
*
First Name
Last Name
Child date of birth
*
-
Day
-
Month
Year
Date
Previous Club(s) (If applicable)
*
Playing Level (Kangaroos OR Wallabies ONLY) and/or experience playing in Academies?
*
Please, select the program in which you wish to register your interest
*
Trial in Elite FC - Join our teams aged from U7 to U13
Elite Clinic - Small Group Training
Goalkeeper Training - (Training day: Saturday mornings)
Elite FC - Female Teams U7 to U13
Other
Parent Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: 0000-000-000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency secondary contact
*
First Name
Last Name
Emergency secondary contact number
*
Please enter a valid phone number.
Format: 0000-000-000.
How did you hear about us?
Medical History: Does your child suffer from any Allergies/Illnesses?
*
No
Yes - (please specify below)
Medical History: Is your child on any Medication?
*
No
Yes - (please specify below)
Does your child have any other injuries or physical difficulties suffered in the past or present:
*
No
Yes - (please specify below)
Authority to Seek Medical Assistance: In case of Emergency I/We authorise the General Manager or Qualified coach of Elite Football to seek Medical Assistance or Ambulance for myself or my child/children & agree to pay all cost incurred. (Please tick below)
*
Yes
Authority to Use Still & Video Content for Advertising Purposes: I give permission for any photos or videos of my child to be used on all platforms of social media eg: Facebook, Instagram, Twitter and Elite Football Centre website and any other as deemed appropriate. (Please tick below)
*
Yes
Refund requests caused by exceptional circumstances (e.g. serious illness or injury) may be considered by Elite Football on an individual basis. Medical certificates will need to be provided although there is no guarantee for a refund. Email will be signed up to the Elite Newsletter
*
Agree
Submit
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