FOOTBALL TECHNIQUE AUSTRALIA
REGISTRATION FORM - TERM PROGRAM
CLUB YOU PLAY FOR? *
Your answer
PLAYER NAME *
Your answer
PLAYER SURNAME *
Your answer
D.O.B *
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EMAIL ADDRESS *
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PHONE NUMBER *
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HOME ADDRESS *
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ANY MEDICAL CONDITIONS? *
If answered yes please identify Medical conditions
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EMERGENCY CONTACT PERSON *
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EMERGENCY CONTACT NUMBER *
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TERM PROGRAM OPTIONS?
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PROGRAM COST
Please note Term Fee does not include the FTA uniform. There is a once off fee. Please tick if you require a uniform.
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PAYMENT METHOD
All payments can be made into the following account:

Football Technique Australia
BSB: 063 - 765
Acc: 1071 3495

*Reference your child's Name*

Payment choice *
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TERMS & CONDITIONS
• Training Camp must be paid in full before training commences.
• If participant cannot attend pre-paid training Camp for whatever reason, money can NOT be reimbursed.
• The only time that a session will be cancelled is when there is lightning, due to ground unavailability or specific Football Technique Australia requirements & a make up day will be made.
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SPORTS RISK WAIVER
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PHOTOGRAPHIC/VIDEO CONSENT & RELEASE FORM
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