Phoenix Futsal Club
Trial Registration Form
Select Age group trialing for
Please Select
Girls Academy 12 and
Boys Academy 11 and under
Boys U12
Girls U13
Boys U14
Girls U15
Boys U16
Girls U18
Youth(17-19)
Womens all age
Mens all age
Last name
*
First Name
*
Birth Date
*
Please select a day
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31
Day
Please select a month
January
February
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April
May
June
July
August
September
October
November
December
Month
Please select a year
2024
2023
2022
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2019
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1920
Year
Mums Name
*
Dads Names
*
Home Phone
Mums Mobile Number
*
Dads Mobile Number
*
Players Mobile Number
House #/Street Name
*
Suburb
*
Postal Code
*
Family E-mail address
*
Previous Futsal Clubs played for
Previous Futsal Clubs played for
Are you interested in sponsoring - Club or individual teams?
*
Yes - Club
Yes - Team
No
Are you Interested in Volunteering
*
Volunteer
Team manager
No
Are you available to help out at the Trials on the 30th June with signs in or uniform fittings?
Yes
No
If yes, what times would you be available to help?
Medical History and/or comments
*
Part of the Phoenix Futsal Club Membership includes PCYC Membership- to process we require parental / player (if over 18)permission
*
I have no objection to my child to joining the PCYC
My Child is already a member - please input membership number below
I do not want my child to join the PCYC
PCYC Membership Number if already of member
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*
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