Inscription form

200,00 $ monthly

Monthly Dues

50,00 $ per season

Registration Fee

Date	Amount
Sep 15,	50,00 $

Childs firstname

Childs lastname

Address line 1

Postcode

City

Mobile

Date of birth

Parent/Guardian Full Name

Parent/Guardian Email Address

Parent/Guardian Phone Number

Emergency Contact Full Name

Emergency Contact Phone Number

Player's Soccer Experience Level

Player's T-Shirt Size

Please list any medical conditions or allergies the player has.

How did you hear about our academy?

Do you consent to photos and videos of the player being used for academy promotional purposes?

Banking Information

Comment (optional)

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