Name of Player:
*
Name of Parent (if under 18yrs old):
Gender:
*
Male
Female
Date of Birth
*
Age:
*
Any Medical Illness?
*
Yes
No
If yes, please state the illness:
Position that you play in:
*
Club or Academy that you are currently playing with?
Programs interested in:
Education
Football and Education
Football
Camps/Clinics
Regions interested in:
United Kingdom
USA
Bermuda
Other
Do you have a Player CV?
Yes
No
Email:
*
Telephone Number:
*
Comment:
By submitting this form, you agree to indemnify and to hold harmless Footy Promotions, its members, coaches, officers or designates from any kind of claim whatsoever.
*
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