Register

To Register:
1. Please read The Parent/Guardian Approval & Medical Release (below)
2. Complete online form
3. Pay appropriate fees

Parent/Guardian’s Approval & Medical Release

Recognizing the possibility of physical injury associated with football and in consideration for the Football IQ Academy and affiliates accepting the registrant for its football programs and activities ( the “Programmes”), I hereby release, discharge and/or otherwise indemnify the Football IQ Academy, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of the fields and facilities utilized for the Programmes against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programmes and/or being transported to or from the same, which transportation I hereby authorize.

My son/daughter has received a physical examination by a physician and has been found physically capable of participating in the Programmes. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of such assistance and/or treatment.

Registration Form

First Name*

Session Registering for: Saturdays

Level Played*

Date of Birth*

Day

Month

Year

Gender*

Parent/Guardian Email*

Parent/Guardian Name*

Surname*

Alternative Contact Name*

Alternative Contact Phone #*

I have read and accepted the Approval & Medical Release*

Parent/Guardian Contact #*

For the Alternative Contact Name and Alternative Contact #, please provide the name and phone number of a person other than the Parent/Guardian and Contact # in the event that we are unable to contact the Parent/Guardian.

How did you hear about Football IQ Academy?*

Search Engine	Referral	Banner / Flyer
Facebook	Coaching Staff	Saw Practice Session
University School

Any Medical Conditions

WebSite

Payment procedures & fees:

1 day/week $500 per term (sibling discount of $25 each sibling).
Academy jersey ($100 on sale at the field)
Players need to bring their own black shorts and black socks (What to bring?)
Payment can be made via:
- Cash in an envelope with your child's full name on it
- Cheque to Francis Cazabon
- Direct deposit to Republic Bank Bank Account # 260000037301 (Chequing) in the name of Francis Cazabon (please email or WhatsApp, 376-6400, an image of the deposit slip/on-line transaction).
Fees are due within the first 2 weeks of the term or at the first session if registering during the term.
LATE PAYMENT FEE ($75)