Registration Form - JTC Johannesburg

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Juventus Training Camp Johannesburg

The King's School Westrand

63 Malcolm Road, Poortview AH, Johannesburg

23 - 27 September (Monday - Friday)

Cost: Rand 6,000

I am aware and I accept that participants are not allowed to bring their cellphones inside the JUVENTUS TRAINING CAMP. *

First Names *

Surname *

Age *

Date of birth *

Physical address

Postal address

School *

Father's name

Father's cell no.

Father's email

Mother's name *

Mother's cell no. *

Mother's email *

Playing position

Medical Aid *

Medical Aid no. *

Medical certificate *

I declare that my child has the medical certificate attesting the ability to attend non-competitive sports activities or equivalent document.

Indemnity Form *

I acknowledge and agree that playing football, being a physical sport and that it is inherent that there is the risk of serious injury, illness and or death. I acknowledge that the risks inherent include but are not limited to risks arising from my child's skill, nutrition and fluid intake, my child's fitness and health, the actions of other players. I accept these risks and confirm that my child participates at my own sole and absolute risk. I accept that all reasonable precaution will be taken to ensure his / her safety and welfare and do hereby indemnify Juventus Football Club and its coaches, The Italian Football Academy (Pty) Ltd, The Football Union and its coaches from any claim, damage, loss, or injury as a result of playing, training, watching, being transported or any other activity. I also hereby proxy to the Juventus Football Club coaches, The Italian Football Academy (Pty) Ltd, The Football Union coaches, in the event of an injury which requires attention, to take whatever steps necessary until I am able to be contacted and hereby accept that I will be responsible for the payment of any medical or / and hospital fees. I undertake that my child / children, members of my family and myself shall abide by the rules set out by Juventus Football Club, The Italian Football Academy (Pty) Ltd, The Football Union and hereby agree to fill any obligations required on my part, including payment of the coaching and registration fees. I have read, understood, acknowledge, and agree to the above terms, exclusions of implied terms, release, and indemnity, as well as the Juventus Child Safeguarding Policy and the Juventus Child Safeguarding Framework and the Protection of Personal Information Act, 2013.

Send

Proof of payment

Please send the completed registration form and proof of payment to:
gauteng@juventus-academy.com

Payment Details

Account Name: The Italian Football Academy (Pty) Ltd
Bank: Nedbank
Account number: 1226577172
Branch Code: 152205
Reference Players Name + Instalment 1 or 2 or 3, in case of payment by instalments