Football Focus soccer academy
 
   
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Please complete the following:

* required field

Program (please specify):
Venue / Date / Time:
Players First Name: *
Players Surname: *
Date of Birth: *
Current Club:
School:
Parent/Guardian Name: *
Address: *
Postcode: *
Home Phone: *
Mobile:
Email (a valid email address is required): *
Medical Information - please note personal medical insurance is recommended but not mandatory.
Medicare number:
Medical Insurance Company:
Medical Insurance Policy Number:
Ambulance Cover: Yes
Please list any condition that may affect your childs participation in soccer (i.e. medical/allegies/behavioural/learning etc):
Where did you hear about us?

To complete your Registration:

NB. Tick box below to accept terms and conditions then submit.

'Registration Successful' page will then appear.

Terms and Conditions
Football is at times a physical, contact sport. By enrolling my child, I declare that they are fit to participate in all activities. As the parent or guardian of the player, I understand that these programs, activities, games and training elements are hazardous by nature and I assume all risks of injuries arising from participation. I release, indemnify and hold harmless Football Focus and its directors, employees and representatives from any claim, demand or action arising in connection with the player's participation.
Use of “The Pitch” or “Titch” is subject to weather conditions.

Consent for Medical Treatment/Liability Release
I hereby indemnify Football Focus against responsibility for any accident, loss or injury suffered by my child/children during the course of these activities. Should at any time Football Focus or staff consider that my child requires medical or hospital treatment, I consent to you obtaining this at my expense. The player's parent or guardian is responsible for any property damage caused by the player. If a player's property is lost or stolen, Football Focus will make every effort to locate it. However, Football Focus accepts no responsibility for the loss or damage to a player's property.

Marketing
I give Football Focus permission to use the player’s picture or likeness in promotion of Football Focus programs in printed or electronic media, including the website. I understand all images are optimised for web use to protect the children. I renounce any claims upon Football Focus for reimbursement for use of this material.
Please advise if you do not wish to receive any further information regarding future programs.


We welcome your feedback; please feel free to contact us before or after sessions. We hope your children have a fun, learning and active experience.

All registrations subject to acceptance of these terms and conditions.

I have read and accept Football Focus’s terms and conditions*

* required field  
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