december 21st

Player Name *

First Name

Last Name

Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would like to hear from Orange Soccer about updates, promotions & exciting things that are happening @ OS HQ. *

Your information WILL NOT be passed onto any external 3rd party bodies.

Yes

No

Academy Photography *

Registrants to the Orange Soccer Academy understand that publicity photographs may be taken during the event and their image/photographic likeness may appear in photographs taken during the Orange Soccer Academy. By registering for the Orange Soccer Academy, you hereby give permission that photos containing your childs image/likeness may be used for publicity or general information purposes including publication on the Orange Soccer Academy web site or within other publicity which may be seen by the general public. The Orange Soccer Academy will not seek any further permission nor provide any notification before using such photos. Please tick to confirm acknowledgement.

I understand

Registration *

Please note - completing this form is a registration of interest and not a booking confirmation. A member of staff will be in touch to take payment, at which point you will receive a confirmation email.

I understand