Registration Form (Kiran)

Registration Form

Lets Play Soccer

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Parent/Guardian Details

Parent First Name*

Parent Last Name*

Relationship to child

Email*

Mobile*

Example: 04xxxxxxxx

Address

Suburb

State

Post Code

Child/Player Details

Child's First Name*

Child's Last Name*

Child's Birthdate

Gender

Does your child has Medical Conditions we should know about

What is your Child's Country of Birth?

What size is your Child?(We will provide a uniform)

About our Program

One Ball offers weekly training in three locations. Lessons are on these days at these time.

Please choose where your child would like to play

The program costs $99 per year. We will send you an invoice once we have confirmed a place for your child on the team.

About your Family

Are you applying for Scholarship

If Yes, Please tell us why you are applying for a scholarship

Reason for applying for scholarship

Other reason for scholarship application

Do you have a health care card?

What languages are spoken in the home?

Please provide Emergency contact

Emergency Contact Name

Emergency Mobile*

Emergency Contact Relationship to Child