England Futsal - Regional Talent Centre Application
If the player in question is under 18, this form should be completed by a Parent/Guardian.
Once the application has been reviewed an email will be sent to the Parent/Guardian providing further details regarding the testing day.
Please select the correct Testing Day Venue
Testing Day Venue *
Player Details
Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Does the player play Futsal? *
Playing Position(s) *
Your answer
Club(s) *
Your answer
Parent/Guardian Email Address *
Your answer
Players Email Address *
Your answer
Parent/Guardian Phone Number *
Your answer
Players Phone Number *
Your answer
Parent/Guardian Occupation(s) *
Your answer
Players Home Address *
Your answer
Living Arrangements (Parents/Guardians) *
Your answer
Players Occupational Status *
Your answer
Highest Educational Qualification *
Your answer
Current University, College or School Details *
Your answer
Educational Aspirations *
Your answer
UK Passport *
Required
Passport Number *
Your answer
Medical Details
Emergency Contact *
Your answer
Emergency Phone Number *
Your answer
Height (cm) *
Your answer
Weight (kg) *
Your answer
GP Name and Address *
Your answer
Allergies *
Your answer
Current Medications *
Your answer
Supplements *
Your answer
Medical Conditions *
Your answer
Private Medical Insurance (if yes provide details) *
Your answer
Previous or Upcoming Operations *
Your answer
Previous Injuries in Past Two Years (all) *
Your answer
Major Injuries in Lifetime *
Your answer
Submit
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