Football Academy Registration Form

Football Academy Registration Form

Register your child for Cornell International Football Academy (CIFA). Please complete all sections accurately.
SECTION 1: PLAYER INFORMATION

Tell us about the player.
Player Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Gender*

MaleFemaleOther / Prefer not to say
Nationality*
Current School (if applicable)
Current Football Experience Level*

BeginnerIntermediateAdvanced / Competitive
Previous Football Academy or Club (if any)
SECTION 2: PARENT / GUARDIAN INFORMATION

Parent or guardian details.
Parent/Guardian Full Name*

First NameLast Name
Relationship to Player*
Phone Number (WhatsApp preferred)*
Please enter a valid phone number.
Email Address*
example@example.com
Residential Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name & Phone Number*
SECTION 3: PROGRAM SELECTION

Choose your preferred program and schedule.
Select Preferred Program Phase*

Foundation Phase (Ages 1–3)Grassroots Phase (Ages 4–6)Junior Development Phase (Ages 7–10)Youth Performance Phase (Ages 11–13)Elite Pathway Phase (Ages 14–16)
Preferred Training Days*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Preferred Training Location (if applicable)
SECTION 4: MEDICAL INFORMATION

Medical and health details.
Does your child have any medical conditions we should be aware of?*

YesNo
If yes, please explain
Allergies (food, medication, environment)
Is your child currently on any medication?*

YesNo
If yes, please specify
SECTION 5: INTERNATIONAL PROGRAM INTEREST

International opportunities and travel.
Are you interested in your child participating in international programs (travel abroad, tournaments, camps)?*

YesNoMaybe / Need more information
Do you currently have a valid international passport for your child?*

YesNoIn process
SECTION 6: PHOTO & MEDIA CONSENT

Consent for use of images and videos.
SECTION 7: LIABILITY & SAFETY CONSENT

Waiver of liability for football activities.
SECTION 8: INTERNATIONAL TRAVEL CONSENT (If Applicable)

Consent for international travel if selected.
SECTION 9: CODE OF CONDUCT

Agreement to uphold academy values and standards.
SECTION 10: DECLARATION & SIGNATURE

Final declaration and confirmation.
Parent/Guardian Full Name (Typed Signature)*
Signature

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Date*

MonthDayYear
Date
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Football Academy Registration Form

SECTION 1: PLAYER INFORMATION

SECTION 2: PARENT / GUARDIAN INFORMATION

SECTION 3: PROGRAM SELECTION

SECTION 4: MEDICAL INFORMATION

SECTION 5: INTERNATIONAL PROGRAM INTEREST

SECTION 6: PHOTO & MEDIA CONSENT

SECTION 7: LIABILITY & SAFETY CONSENT

SECTION 8: INTERNATIONAL TRAVEL CONSENT (If Applicable)

SECTION 9: CODE OF CONDUCT

SECTION 10: DECLARATION & SIGNATURE