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Registration Packet complete (2).pdf

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Registration Form 2014
Child’s Full Name (First and last):______________________________________________________
Please tick: Boy ( ) Girl ( )
Date of Birth: _____________________________ Present Age: ________________
Please attach photocopy of Birth Certificate/ NRC/ Passport for proof of AGE with the registration form and a
passport size photo.
School: _________________________________________
Home tel: _____________________________
Mother’s Cell No._________________________

Father’s Cell No. _________________________

Email address: _____________________________________________________________________
Street Address: _____________________________________________________________________
Car Registration number: (1)______________________________(2)__________________________
In the event of an emergency, and a parent is not available, please list an alternate contact person and their
telephone number:
Emergency Contact person: ___________________________Cell phone number: _____________________
Name of clinic: ___________________________
List any medical conditions, allergies or important medications of which we should be aware:
Player information:
Please circle the appropriate:
Does your child play on the school team in the ISAZ league: Yes
What position do you play? Goalkeeper




Mid field


How many years have you been playing? ________
How do you rate yourself as a player?



Above Average

Please list any additional information you feel is relevant: