2017 Registration Form (UNDER 11) -
Registrations Closed - Waiting list

Participant Details

First Name *
Please enter participant first name.

Participant's First Name

Last Name*
Please enter participant's last name

Participant's Last Name

Date of Birth*
Please select a dayPlease Select the monthPlease select year of birth

Gender*
Please select the gender.

height*
Please enter the height

cms

School*
Please enter the school name

Residential Address *
Please enter you residential address

City*
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Pin-code*
Please enter correct pincode

Primary Contact Person*
Please select one

Primary Email*
Please enter a valid email id.

for all communication

Primary Mobile Number*
Please enter a valid phone/mobile no.

Kit Size*
Please select one

Click here to see Jersey Size Specifications

Prior Football Experience*
Please select one

Would you like to be a Goalkeeper*
Please select one

Medical Condition
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current injuries or minor physical limitations or medical condition coach or organisers should know

Upload Photo
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Max file size: 5MB

Upload Date of Birth Proof
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Birth certificate or Passport Copy

 

Parent Details

Father's Details

Father's First Name *
Please enter father's first name

Father's Last Name *
Please enter father's last name

Father's Email*
Please enter a valid email id.

Father's Mobile Number*
Please enter a valid phone/mobile no.

Mother's Details

Mother's First Name *
Please enter mother's first name

Mother's Last Name *
Please enter mother's first name

Mother's Email*
Please enter a valid email id.

Mother's Mobile Number*
Please enter a valid phone/mobile no.

Volunteer

Would the parent like to volunteer ?*
Please select one

Are you a student of Roots Football School?
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Is your sibling also playing RFL
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