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All information to be CLEARLY PRINTED * * Click the PRINT icon to the right to print a copy of the REGISTRATION FORM. CLICK HERE TO PRINT
LAST NAME: ___________________________________ FIRST NAME: ____________________________________ PASSPORT COUNTRY :____________ DATE OF BIRTH: Day/Month/Year _____/_____/_____ HEIGHT: _________________cms ADDRESS: (NO P.O. Box addresses)_____________________________________________ SUBURB: _____________________________STATE:_______________ POSTCODE: _______ GENDER M / F (circle one) Contact Number: ________________________e-MAIL :_____________________________ CURRENT CLUB: _____________________________________AGE/DIVISION:_____________ PREFERRED FOOT:_________________ POSITION:____________________________DISTRICT/ASSOCIATION:___________________ ARE YOU REGISTERED WITH A REPRESENTATIVE TEAM THIS YEAR? YES/NO (circle one) If YES, which team:___________________________________________________________ ADDITIONAL ELITE TRAINING/ACADEMY:___________________________________________ PLAYER REGISTRATION DECLARATION: I hereby declare (a) I am not under suspension by any sporting organisation. (b) I am duly qualified to play for the team I have listed according to the rules of the Association. (c) I will inform Australian Football Players of any change to the above details. I hereby declare that all the information submitted on this form is correct. (Parent/Guardian accepts responsibility on behalf of a minor). *** Australian Football Players :DECLARATION (Approval - Photographic or Film Image) I agree to Australian Football Players using my name and image in the promotion and marketing of Australian Football Players, the programs that are conducted and the commercial relationships that are entered into in connection with those programs. PARTICIPANT APPROVAL or PARENT/GUARDIAN APPROVAL (if participant is under 18): Signed: …………………………….. Name: …………………………Date: ……./……./… Please return this form by post to : Australian Football Players, PO Box 3372. Wetherill Park,2164 NSW Australia Payment By DIRECT DEPOSIT, INTERNET BANKING, Cheque, Money Order, Secure PayPal
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: Australian Football Players St George Bank: BSB: 112-879 A/C: 428796581 PLEASE INCLUDE: 1) Completed form 2) Passport sized photograph of player 3) Cheque or Money Order * *DO NOT SEND CASH! DO NOT STAPLE PHOTOGRAPH TO THIS FORM! PHOTOS WILL NOT BE RETURNED** Registration FEES: (please tick the box) Association 13+ Players:$20.00□ Association Players 18+ $30.00□ PREMIER/State Players:$50.00 ***REGISTRATION FEES CAN NOW BE MADE VIA SECURE PAYPAL FROM YOUR COMPUTER*** Please refer to our terms & conditions for further information relating to registration and services provided by Australian Football Players. Registration is valid for 12 months from time information and payment is received. Registration Fees are non refundable.Please ensure the CD is clearly marked with the players full name and address.CD's will not be returned. File must be in mpeg format. Clips will be linked to players profiles and viewed on YOUTUBE. |