Registration / Programs

Can Player Participate in Club's Marketing Events Including But Not Limited To Social Media?

Yes No

Who Provided or Declined Consent for Player to Participate In Clubs Marketing ?

Parent of Player under 16 Player age 16 and above

Uniform

Select Jersey Size

Select Short Size

Select Track Suit Size

Track Suit Jacket (Large) Track Suit Jacket (Medium) Track Suit Jacket (Small) Track Suit Pants (Large) Track Suit Pants (Medium) Track Suit Pants (Small) Track Suit Jacket KIDS (XS) Track Suit Pants KIDS (XS)

Player Position(s)

Parent's Information

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***Credit Card Information is Now Required for All Registration

Type Of Credit Card ?

VIsa MasterCard Visa Debit

Pos	Team	P	W	D	L	F	A	GD	Pts
1	Cap U	0	0	0	0	0	0	0	0
1	Gloucester Celtic	0	0	0	0	0	0	0	0
1	WOS	0	0	0	0	0	0	0	0
1	XSA - JP	0	0	0	0	0	0	0	0
1	XSA-CP	0	0	0	0	0	0	0	0

Pos	Team	P	W	D	L	F	A	GD	Pts
1	Cap U	0	0	0	0	0	0	0	0
1	Gloucester Celtic	0	0	0	0	0	0	0	0
1	WOS	0	0	0	0	0	0	0	0
1	XSA - JP	0	0	0	0	0	0	0	0
1	XSA-CP	0	0	0	0	0	0	0	0

Registration / Programs

Social Media & Marketing

Uniform

Parent's Information

***Credit Card Information is Now Required for All Registration

All Information are kept Confidential & Secure in an encrypted data vault offline and will be destroyed upon Leaving the Club. / Credit Card Will Not Be Debited If Payments are Made in Full or, are Paid on Time by the 5th of Each Month

By hitting Submit, you agree to the terms & conditions of this registration form and the accuracy of the information provided

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X-Uvia Professional Soccer Academy

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