Futuresportz Talent Academy

Coaching Application Form

Application to join Futuresportz Athlete Roster.

Please fill in all the information and then Submit to apply. You MUST answer those fields with a red *.

Whilst all care is taken, it is aknowledged that participation in Futuresportz training & coaching programs is at the client's own risk.

By submitting the form you accept this, and confirm that you have read the Coaching Policy (includes costs).

Family Name *		Athlete's Surname

Given Names *		Athlete's Given Name(s)

Date of Brth *		Date of Birth ~ Note: for competition a birth certificate may be required

Age *		Athlete's age at time of application

Address *		Postal Address

email *		email address for electronic communications

Home Phone *		Primary contact phone number

Mobile		Mobile contact phone number

Website Login *		A login name for our website (no spaces or punctuation marks)

Website Password *		Password for the website login (no spaces or punctuation marks)

Fathers Name		Father's Name (father OR mother MUST be supplied)

Mothers Name		Mother's name (father OR mother MUST be supplied)

School		Current school attended

School Grade		Grade (year) at your school

Medical		In confidence - let us know of any medical ailments, medicinal treatments, injury or any other concerns that we should know about.

Training Soreness		Please let us know if your child complains about any soreness or pain after sports/physical activity

Sports Experience *		Tell me about your child's experience and any representative teams achieved

Club-School		The club or school they compete for