2025 Registration Form - Football SA Junior & MiniRoos Boys Competition

Thank you for your interest in registering for the 2025 season at West Torrens Birkalla.

This form is appropriate for boys wanting to register for the MiniRoos (U5-U11) teams and Junior Boys Competition (U12-U17) in 2025.

All players looking to play in the U10-U17 age groups must attend trials. All parents/guardians must complete this form at least 24 hours prior to the start of trials. If new to the club, proof of age must be brought to the trials and presented to the registration desk. Proof of age can be passport/birth certificate/School ID card/drivers licence (learners or P's)/photo ID confirming date of birth

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* 1. Player First Name

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* 2. Player Surname

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* 3. Home Address

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* 4. Player Email Address (optional)

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* 5. Player Mobile Number (optional)

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* 6. Player Birth Date (DD/MM/YYYY)

Birth Date

Date

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* 7. Club played in 2024

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* 8. Club Played in 2023

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* 9. Player's FFA Number - leave blank if unknown

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* 10. Which age group will the player be trialling /registering for?

U5 (born 2020/21)

U6 (born 2019)

U7 (born 2018)

U8 (born 2017)

U9 (born 2016)

U10 (born 2015)

U11 (born 2014)

U12 (born 2013)

U13 (born 2012)

U14 (born 2011)

U15 (born 2010)

U16 (born 2009)

U17 Born (2008)

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* 11. Are you trialling for a Goalkeeper position?

Yes

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* 12. Mother's Full Name

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* 13. Mother's Email Address

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* 14. Mother's Contact Phone Number

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* 15. Father's Full Name

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* 16. Father's Email Address

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* 17. Father's Contact Phone Number

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* 18. If successful, will both parents be responsible for payment of fees?

Yes

No, mother is responsible for payment of fees

No, father is responsible for payment of fees

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* 19. Does the player suffer from any of the following medical conditions?

No, there are no known medical conditions

Asthma

Diabetes

Epilepsy

Allergies

Other (please specify)

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* 20. If you have indicated that the player suffers from a medical condition, please make any further comments that may be necessary, and may provide further information on management of the condition.

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* 21. As a community club, we rely on the generosity of time from volunteers, many of whom are parents.

As the parent, would you be willing to consider any of the following roles:

Coach

Assistant Coach

Team Manager

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* 22. I/My child hereby agree(s) that West Torrens Birkalla Soccer Club ("The Club") including any of its officers and/or members shall not be held responsible for any accident, illness or injury sustained by me/my child while playing at, or attending any function with, The Club. I understand that The Club carries only basic player’s insurance (provided through registration with FFA) and that it is my responsibility to arrange additional insurance cover. The Club recommends that every player takes out their own private health insurance including ambulance cover. Although players are covered by the FFA Group Personal Accident Insurance whilst playing or training, the Club will not be liable for any cost not covered by the FFA insurance that shall be for the account of the players. I also give my permission for The Club to arrange medical attention for me/my child that may be deemed necessary including ambulance transport and I agree to pay for all such costs incurred. The Club agrees that it will do its utmost to contact either parent, if possible, prior to seeking medical treatment for my child, but I understand and accept that it may not be possible to do so in all circumstances. The Club agrees to contact either or both parents as soon as it is practicable to do

I agree to the above

I do not agree to the above

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* 23. Disclaimer: West Torrens Birkalla Soccer Club is not obligated to accept any or all children who trial to play at West Torrens Birkalla. In addition, our Technical Director/s will determine the appropriate squad or team, which is the best age environment and/or applicable skill level, that is most conducive to the development of the child to play soccer. Our decision to where players are placed is final and may be subject to change at the requirement of the club prior to or during the season.

In being offered a position at WT BIrkalla on behalf of my child, I understand that I will be required to pay a 50% deposit of the club fees to accept the position. This deposit is non-refundable. The remainder of the fees will be paid prior to 31st January 2025. All fees will be required to be finalised before the start of the 2025 season if a payment agreement has been made with the club registrar.

I understand and agree to the above disclaimer

I do not agree to the above disclaimer

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* 1. Player First Name

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* 2. Player Surname

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* 3. Home Address

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* 4. Player Email Address (optional)

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* 5. Player Mobile Number (optional)

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* 6. Player Birth Date (DD/MM/YYYY)

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* 7. Club played in 2024

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* 8. Club Played in 2023

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* 9. Player's FFA Number - leave blank if unknown

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* 10. Which age group will the player be trialling /registering for?

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* 11. Are you trialling for a Goalkeeper position?

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* 12. Mother's Full Name

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* 13. Mother's Email Address

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* 14. Mother's Contact Phone Number

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* 15. Father's Full Name

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* 16. Father's Email Address

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* 17. Father's Contact Phone Number

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* 18. If successful, will both parents be responsible for payment of fees?

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* 19. Does the player suffer from any of the following medical conditions?

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* 20. If you have indicated that the player suffers from a medical condition, please make any further comments that may be necessary, and may provide further information on management of the condition.

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* 21. As a community club, we rely on the generosity of time from volunteers, many of whom are parents. As the parent, would you be willing to consider any of the following roles:

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* 24. Parent/Guardian "signature" - please state your name

* 21. As a community club, we rely on the generosity of time from volunteers, many of whom are parents.

As the parent, would you be willing to consider any of the following roles: