Northern Stars Holiday Clinic Registration Form

  • Northern Stars Football Academy Holiday Clinic June/July 2026

  • You will need to fill out one registration per player. 

  • PLAYER INFORMATION:

  • PARENT/GUARDIAN INFORMATION:

  • MEDICAL INFORMATION

  • Photograph and Video Disclaimer

  • At Northern Stars Football Academy we aim to provide a safe, enjoyable and positive experience for all participants. During the sessions, we would sometimes like to take photos and film some of the sessions. Sometimes we may use these for publicity, marketing and social media. In the interests of safeguarding and the player’s welfare we are asking for your permission to take photos/video footage. 

  • Do you consent to allowing images of your child on our socials?*
  • Holiday Clinic(s) selected*

  • Please transfer funds into the following bank account:

    Account Name: Northern Stars Football Academy

    BSB: 084970

    Account Number: 238099944

    Reference Number: Players Full Name

  • Payment Details

  • By submitting this form, I, as the parent/guardian of the registrant, consent to emergency medical treatment being administered by a registered medical practitioner or dentist, as deemed necessary to protect the registrant’s life, health, or well-being.

    By submitting this form, I, the parent/guardian of the registrant, who is a minor, agree to adhere to the rules and regulations of the Northern Stars Football Academy, including its affiliated organisations and sponsors. I acknowledge the potential risks of physical injury associated with soccer and, in consideration of the Northern Stars Football Academy accepting the registrant into its soccer programs and activities (the "Programs"), I hereby release, discharge, and indemnify the Northern Stars Football Academy, its affiliated organisations and sponsors, their employees, and associated personnel, including the owners of any fields and facilities used for the Programs. This release covers any claims made by or on behalf of the registrant arising from participation in the Programs or during transportation to or from the Programs, which I authorise.

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