Football Focus soccer academy
 
   
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To register please complete the online form.

Alternatively download a copy here: Registration form

NB: If confirmation page does not appear after submitting form online please download and return registration form by email or post - thank you.

PAYMENT OPTIONS

Scroll to bottom of registration

form for payment options including BSB details.

 

 

 

Please specify the program you are registering for:

Program:
Venue / Date:
Players First Name: *
Players Surname: *
DOB: *
Current Club:
School:
Parent/Guardian Name: *
Address: *
Postcode: *
Home Phone: *
Mobile:
Email: *
Medical Information - please note personal medical insurance is recommended.
Medicare number:
Medical Insurance Company:
Medical Insurance Policy Number:
Ambulance Cover: Yes
Please detail any player medical condition / allergy / other that we should be aware of:
Where did you hear about us?

Registration Conditions
All registrations are subject to the acceptance of the terms and conditions of Football Focus.

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.
“The Pitch” and “Titch” are 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 permission to Football Focus 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 (forms will be provided); please feel free to contact us before or after sessions.
We hope your children have a fun, learning and active experience.

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

* required fields  

PLEASE SEND PAYMENT TO:
FOOTBALL FOCUS. PO Box 2008, KENT TOWN 5071

Payment: Cash, cheque / postal note (payable to Football Focus)
or EFT: Football Focus, BSB. 105136Acct. 044686140

 

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