GLOCAL FOOTBALL ACADEMY PLAYER REGISTRATION FORM

PLAYER REGISTRATION

RISING STAR
PLAYER NAME*

First NameMiddle NameLast Name
DATE RESIGTRATION*

DayMonthYear
TAKE PHOTO*
HOME ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DATE OF BIRTH*

DayMonthYear
AGE
GENDER*
HANDPHONE NUMBER*
12-3456789
EMAIL*
example@example.com
DESIRED FOOTBALL TEAM
NAME OF SCHOOL*
PLEASE STATE MEDICAL HISTORY
IF NO LEAVE IT BLANK
TEAM APPLICATION
UNDER 6

4 YEARS OLD - 6 YEARS OLD
UNDER 8

7 YEARS OLD - 8 YEARS OLD
UNDER 10

9 YEARS OLD - 10 YEARS OLD
UNDER 12

11 YEARS OLD - 12 YEARS OLD
UNDER 15

13 YEARS OLD - 15 YEARS OLD
UNDER 18

16 YEARS OLD - 18 YEARS OLD
UNDER AGE*
PLEASE WRITE UNDER
DESIRED POSITION*
JERSEY SIZE
EMERGENCY CONTACT
NAME*

First NameMiddle NameLast Name
HANDPHONE NUMBER*
12-3456789
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
RELATION*
PARENTAL / GUARDIAN CONSENT
Waiver

I am fully aware that this sport activity may cause accidental injury to athletes. I likewise assume any and all possible risk that may cause injury, illness arising to such activity. I hereby declare that I waive my right to pursue any and all claims against the Commission and the Organizing Committee of this event should in any case that the accident, injury, illness occurs in the course of any activity held by them.
Signature of Parent / Guardian*

Clear
NAME*

First NameMiddle NameLast Name
DATE SIGNED*

DayMonthYear
Should be Empty:

PLAYER REGISTRATION