Presented by: Program Year / Season: PLAYER INFORMATION Full Name Date of Birth Age Group Gender: Male Female Other Citizenship / Passport Country: Passport Number: Expiration Date: Address: City State/Province: Postal Code: Country: Player Email: Player Phone: PARENT / GUARDIAN INFORMATION (if under 18) Parent / Guardian Name: Relationship: Phone: Email: SOCCER BACKGROUND Current Club / Academy Current Team / Level Primary Position Goalkeeper Defender Midfielder Forward Secondary Position Years of Experience Dominant Foot Right Left Both Coach Contact: PLAYER DEVELOPMENT GOALS Please check your main interests: International Tournament Experience College Showcase & Scouting Opportunities Professional Club Exposure Cultural Exchange & Travel Experience Advanced Player Development Training Personal Statement / Goals: MEDICAL INFORMATION Do you have any existing medical conditions or injuries? No Yes Allergies: Medications: Emergency Contact Name: Relationship: Emergency Phone: TRAVEL DOCUMENTATION I have a valid passport (must be valid for at least 6 months from travel date) I will apply for a new passport I need assistance obtaining travel documents Visa Requirement (if applicable): Yes No PROGRAM PACKAGE SELECTION Player Package Full tour participation + training + games + hotel Parent/Guardian Package Accommodation + access to all events Training-Only Package Development sessions + showcase only Preferred Payment Option: Deposit Full Payment Payment Plan TERMS & CONSENT I acknowledge that international travel involves inherent risks, and I release the organizers, coaches, and staff from any liability for injury, loss, or damages during the program. I certify that all information provided above is true and accurate. Date: Parent / Guardian Signature (if under 18): OFFICE USE ONLY Registration Date: Registration Date: Travel Documents Verified Yes No Medical Form Received Yes No Assigned Coach Notes Submit 2025-10-29
