Short Name
*
Full Player Name
*
Today Date
-
Day
-
Month
Year
Date
Date Of Birth
*
-
Day
-
Month
Year
Date
Age
Gender
*
Please Select
Male
Female
Email
*
example@example.com
Contact Number (Whatsapp):
*
-
Country Code
Phone Number
Parent Name
Parent Contact Number (Whatsapp):
-
Country Code
Phone Number
Address
*
Jersey size (subject to. Availability)
*
Please Select
XS Kids
S Kids
M Kids
L Kids
S Adult
M Adult
L Adult
XL Adult
XXL Adult
XXXL Adult
Join Date
*
-
Day
-
Month
Year
Date
Program (sessions and payments)
*
Please Select
1 session per week IDR 800.000 for 1 month in advance
2 session per week IDR 1.000.000 for 1 month in advance
3 session per week IDR 1.200.000 for 1 month in advance
1 session per week IDR 2.160.000 for 3 month in advance
2 session per week IDR 2.700.000 for 3 month in advance
3 session per week IDR 3.240.000 for 3 month in advance
1 session per week IDR 8.160.000 for 12 month in advance
2 session per week IDR 10.200.000 for 12 month in advance
3 session per week IDR 12.240.000 for 12 month in advance
Training Schedule
Monday - 16.00-17.30 (All ages except U6)
Thursday - 16.00-17.30 (All ages except U6)
Saturday - U8-U10 (2015-2018) : 07.30-09.00, U6 (2019-2025) : 09.00-10.00, U12-U14 (2011-2014) : 09.00-10.30, U16-U17 (2009-2010) : 11.00-12.30
School
*
NISN
Upload Photo (3x4)
*
Birth Certificate / Passport
*
School Report (Biodata page only)
*
Any allergies, medications or other medical conditions we should be aware of?
Does the participant have medical insurance?
*
Please Select
Yes
No
Terms and Conditions
*
I acknowledge to transfer the signup fee (IDR 1.000.000) and the program fee to the German Football Indonesia account: CIMB NIAGA 7071 7077 6200 and send the transfer slip via WA to +62 8111 8898 205.
I agree to wear the Borussia M'Gladbach Academy Indonesia (BAI) outfit at all training sessions and matches. Football socks and other non-Borussia items should be in neutral colors (ideally black). Please do not display Logos and Merchandise of other clubs and leagues beside Borussia Mönchengladbach and the Bundesliga.
I acknowledge that participation in the football academy involves physical activities, and I assume all risks and hazards incidental to such participation. I hereby waive, release, and forever discharge the football academy, its directors, officers, employees, agents, and volunteers from any and all liability, claims, demands, or causes of action whatsoever arising out of any damage, loss, injury, or fatality to me or my child, while participating in the events.
I acknowledge that images and videos taken may be used for promotion; including but not limited to press release; publicity materials including newsletters, magazines, brochures, websites and social media. Images and videos will not be accompanied by names or other personal details that could identify individual children or young people.
Notes and comments
Submit
Should be Empty: