Football Academy Registration

Player Details

First Name*

Middle Name

Your Surname*

Email Address*

Is this the email address of the player or parent/guardian?PlayerParent/Guardian

Phone/Whatsapp Number

Phone number of the parent/guardian can be filled in. This will be used for activity updates.

Is this the number of the player or parent/guardian?PlayerParent/Guardian

Where do you live?*

Please state your residential home address

City

State

What is the name of the player's school?*

Player's SexMaleFemale

What is the player's date of birth?

How old is the player?*

Academy Program of Interest*

Player's passport photo*

Upload a passport photo of the player (1mb filesize limit)

Parent/Guardian Details

Father's full name

Father's phone number

Mother's full name

Mother's phone numner

Full name of Guardian

If the parents are not responsible for the player, please state name of a Guardian.

Guardian's phone number

Parent/Guardian Email Address to contact

Person Authorized to pick up child

Authorized person's ID

Please upload a picture of the person's ID (1mb filesize limit)

Emergency Contact

Who do we contact in case of an emergency?*

Relationship to player*

Phone number of Emergency contact*

Medical Details

Is the player on any medicationYesNo

If "yes", please specify

Specify any of the player's health problems

Name of Player's Doctor

Doctor's Phone Number

*You have our permission, in the event of an emergency and in case we are unavailable, to authorize any physician, nurse practitioner or medical personnel to examine, interview, test and if necessary, treat my child as they may deem advisable.

Preferred Payment Plan*

Please note that payment for the uniform kit is not included in the academy fees. Players who do not have the academy branded uniform kit will not be able to represent the academy in games against other academies.

Who is financially responsible for the student?*

*I hereby give permission to Radial Sports Ventures Ltd to photograph and/or videotape my ward for educational or promotional purposes.

Parent Statement

I hereby state that my child/ward is in good mental and physical health condition to participate in the activities provided by Radial Sports Ventures Ltd including but not limited to all aspects of football and or competition. I am fully aware that any activity involving motion or athletic activity creates the possibility of serious injury. I hereby release Radial Sports Ventures Ltd, its employee and staff from liability to the above-named player, of the person claiming through him/her, arising from injury to the person or property of the above-named player occurring on the premises of Radial Sports Ventures Ltd including any event sponsored or sanctioned by Radial Sports Ventures Ltd and or travel to and from such activities.

I understand that Radial Sports Ventures Ltd has the right to deny admittance to any player not meeting the standards of the program as it sees fit. I also agree not to hold these parties responsible in the event that my son/daughter/child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior in or out of the academy grounds, etc.) or becomes involved in any activity or with any persons not associated with Radial Sports Ventures Ltd or its scheduled program and that Radial Sports Ventures Ltd has the right to send him/her home for inappropriate conduct. I further attest that the information contained in this application is correct to the best of my knowledge. In addition, I have agreed to the policy and fee statement and agree to comply.

*I accept the Parent Statement.

WORK TIME: 09:00 - 17:00

FIND US: Ajah, Lagos

CONTACT: 0913 467 4040

FOLLOW US:

Football Academy Registration

Join the Radial Sports Academy

Registration Form

Player Details

Parent/Guardian Details

Emergency Contact

Medical Details

Parent Statement

About Radial Sports

Quick Links