2025 Futsal Registration Form Term 4

Futsal Registration Form Term 4

Boys & Girls U7 - U12
Venue: Morris Iemma Indoor Sports Centre

150 Belmore Rd North, Riverwood NSW 2210
Dates

Every Monday starting 13 October to 15 December
Time

U7 - U9s 5:30 - 6:30pm; U10 - U12s 6:30 - 7:30pm
Player Name*

First NameLast Name
Player Date of Birth*

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

First NameLast Name
Phone Number (Parent/Caregiver)*
Format: 0000000000.
Email (Parent/Caregiver)*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Postcode
NEW FUTSAL PLAYERS
UNIFORM PURCHASE REQUIRED

First-time BFA registrants must purchase the official BFA Uniform (Hero Jersey + Hero Shorts) via our online shop.

ACCESS THE BFA SHOP

We recommend purchasing your uniform as soon as you can. You can also find a link to the shop on our website. 😊
Payment Instructions
$320 per player

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

Cancelof
I am aware of my child participating in this 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 (parent/caregiver)*

Clear
Should be Empty:

Futsal Registration Form Term 4

Venue: Morris Iemma Indoor Sports Centre

Dates

Time

Payment Instructions