Player's First Name *

Player's Last Name *

Emergency Contact Name *

Emergency Contact Phone Number*

What are you registering for?

If you are registering for Adult Tournament, please select the Represented Country:

If you are registering for “Youth” Tournament please provide Team Name:

Your E-mail *

Phone Number

Players Birth Date *
Month: Day: Year:

Your Address *


City

Province

Postal Code

Country

I agree that the player will abide by the rules and regulations of Africa United FC, its affiliated organizations and sponsors. In consideration of the player's participation in the soccer programs intending to be legally bound, I hereby release and indemnify Africa United FC, and its owners and operators of the facilities used for the programs and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player's participation in the program including, without limitation, player's transportation to/from any program, which transportation is hereby authorized.

Do you agree with the terms? *
Yes , I agree

Comments

* are mandatory fields