COE Trials 2018 - Registration

COE Trials 2018 - Registration

Complete the form below to sign up for the 2017 COE Under 8 Football Trials
Player Name*

First NameLast Name
Birth Date:*

DayMonthYear
2017 Club*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Father Name:*
E-mail*
Phone Number Father:*

Phone Number
Mother Name:*
E-mail*
Phone Number Mother:*

Phone Number
Declaration

I hereby state that I have been informed that I am responsible for my own insurance while trialling with the St George Football Association. I agree that in the event of an injury sustained by me, the Association is hereby indemnified against any action by me to recover any medical costs not covered by my personal medical insurance cover and the insurance policy provided through Football NSW Limited (if applicable).
I have read, understood, and accepted the Declaration.
Signature*

Clear
Should be Empty:

Declaration