Performance Program EOI Registration
Please complete this enrolment application form to register your interest in this program.

Full program details at
http://academy.curtin.football
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Player Details
Player First Name *
Player Last Name *
Player Date of Birth (dd/mm/yyyy) *
MM
/
DD
/
YYYY
Confirm player year of birth (yyyy) *
Player Gender
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Residential Suburb *
Residential Post Code *
Your Club Name *
Required
Player's Years of Experience *
Required
Current FFA Registration *
Was your child registered on www.playfootball.com.au to play in the last 12 months.
Required
Parent/Guardian/Emergency Contact Details
Parent/Guardian Name *
Please enter your first and last names, eg John Citizen
Parent/Guardian Mobile *
Other Information
Program Communications *
To stay up-to-date and be informed of session cancellations, etc you must join our communications system (www.teamapp.com) and download the app.
Notes for Registrar
If required, add a note for the registrar.
Submit
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