Footy Force Membership
Step 1 of 2: Submit
Applicant Name:
*
Date of Birth:
*
Age Group
*
Select an option:
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7-9 year old
10-12 year old
13-16 year old
Player Size:
*
Select an option:
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Any Illness (if yes, please explain):
Parent or Guardian:
*
Home Mailing Address:
*
Home Phone:
*
Cell Phone:
*
Email Address:
*
Amount Paid
*
Select an option:
Renewal - $150
New Member - $185
Interested in purchasing Tracksuit?
Yes
No
Pay By:
Direct Deposit
Cash
Check
By submitting this form, you hereby agree that Footy Promotions / Footy Force Futsal Academy, its members, coaches or officers, shall not be liable for any injury
or loss which my child or children may sustain while participating in activities of any kind, whether sponsored by or under the supervision of the Footy Promotions / Footy Force Futsal Academy.
We agree to indemnify and to hold harmless Footy Promotions / Footy Force Futsal Academy, its members, coaches, officers or designates from any kind of claim whatsoever.
Parent or Guardians Please Initial Here To Sign:
*
Date:
*
*
indicates required fields