Pitt Town Academy Training - Player Registration

Pitt Town Academy Training - Player Registration

8 week program - All training sessions run by ASA Football
PROGRAM INFORMATION
8 week pre-season training program
On Monday evenings at Pitt Town Sporties

For ages 6 - 16

ALL training sessions to be run by ASA Football

Cost: $330 per player

Times:
6:30 - 7:30pm ages

Dates:
(February 9 to March 23)

Notes:
- Upon completion and payment of this registration, you will be contacted by ASA Football confirming your enrolment and given any further details.

If you have any further questions, please contact info@asafootball.com.au
Player Registration Details
Name*

First NameLast Name
DOB (DD/MM/YYYY)*
Gender*

MaleFemale
Please provide any details of medical conditions/allergies that may affect the player's participation in this program.
Parent/Guardian Contact Information
Name*

First NameLast Name
Contact Email*
Contact Number*
Risk Warning and Media Consent
I agree for my child to attend the program and to undertake all activities and/or to participate in the above program. In the case of an emergency, I authorise ASA Football where it is impracticable to communicate with me, to arrange for my child to receive such medical or surgical treatment as may be deemed necessary. I also undertake to pay or reimburse costs which may be incurred for medical attention, ambulance transport and drugs while my child is attending the program.

To allow ASA Football to use:
photographs, sound and fi lm recordings taken of my child at this program only for the promotion of ASA Football services and initiatives to the media and to the general public. I understand that although ASA Football and its service providers attempt to remove and minimise any risk of personal injury within practical boundaries, accidents do happen and all physical activities carry the risk of personal injury. I acknowledge that there is an inherent risk of personal injury in physical activities that will be undertaken in the program and I accept that risk.
I consentI do not consent
No Refund Policy
I understand that I will not be able to request or receive a refund for program once paid for upon registration. If any sessions are cancelled due to weather/ground closures - Players will be able to make up these sessions at another ASA Football campus.
Parent/Guardian Signature*

Clear
Payment

Paid in full at time of registration - Please note: Deduction will show on your statement as "Polisport International"
My Products*
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8 week Pitt Town Football program
$330.00AUD Quantity

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Pitt Town Academy Training - Player Registration

Player Registration Details

Parent/Guardian Contact Information

Risk Warning and Media Consent

No Refund Policy

Payment