Brisbane Roar Futsal Academy Program

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Welcome to the Brisbane Roar Academy Futsal Expressions Of Interest form. Please hit NEXT to get started!
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Parent/ Guardian's Names* This field is required.Please enter at least two Parent or Guardian's names
Parent 1 - Full Name
Parent 2 - Full Name
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How many children do you have interested in the Brisbane Roar Futsal program?* This field is required.
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Please enter the name of your child/ children interested in the Brisbane Roar Futsal Academy Program(Please enter 1 full name per line if you have multiple children interested)
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Please enter your child's Date Of Birth:If multiple children, please enter each child's DOB on seperate lines:
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Choose your desired Futsal Academy HubChoose one of the two available Hubs located closest to you:
Metro Brisbane Futsal Academy centre
Southern Brisbane Futsal Academy centre
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Parent/ Guardian Contact Numbers* This field is required.Please Enter 2 contact numbers PLUS an emergency contact number
Mobile Number 1
Mobile Number 2
Emergency Contact Number
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Parent/ Guardian Email Address* This field is required.Please Enter your best email address
Email Contact 1
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2020 Registered Football/ Futsal ClubsPlease tell us the football and/or Futsal clubs your child/ children have been registered with in the most recent season/s, along with the program they played in (E.g. Lions FC U12 SAP):
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Football & Futsal Positions PlayedPlease enter the positions your child/ children generally play in both Football and/ or Futsal
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Your child's current school & gradePlease enter which school & grade your child/ children currently attend
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Known Medical ConditionsPlease Enter any known medical conditions your child/ children may have
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Key Information & FAQ's
*Before Continuing - Please Read the below information to answer any questions you may have about the Brisbane Roar Academy 2020 Futsal Program:

1. Two Locations: Brisbane Metro and Brisbane South

Brisbane Metro Hub Location:

2. YMCA Bowen Hills 95 Abbotsford Road
BOWEN HILLS, 4006

Days- Sundays

Times – 9.00am – 2.00pm

Specific age group training will be advised upon application

Age Groups – 8s to 16 Boys 12s girls & 16s girls

Brisbane South Hub Location:
Insports Cornubia- 146 Bryant Road Shailer Park
And
Mt Warren Sports Centre – 2 Milne St Beenleigh

Days- Sundays
Times – 2.30pm- 5.30pm
Specific age group training times will be advised upon application
Age Groups – 8s to 16s Boys + 14s girls

- There will be a maximum of 10 players for each team / age group.

3. Futsal Specific Coaching Staff

Metro
Pablo Coletti
Justin Morrison
Connor George
Dane Dawson

South
Rhys Parkes
Vinnie Leite
Paul Owen
Barry McErlean

3. Fees Inclusions

Court Hire

Professional Futsal Coaches

Uniform / Tournament entry & registration / Insurance sold seperately

Umbro Academy Uniform: http://bit.ly/2oxcLs6

If your child fits the above age groups and is interested in the program, please proceed to Express Your Interest by selecting the NEXT button below.

If you have any questions or queries, please contact: futsal@brisbaneroar.com.au

Thanks,
BRFC Academy
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