PLAYER INFORMATION

Name*
Gender*

MaleFemale

Candidate Photo

Date of Birth*

Division:
Height

Weight

School

Current Grade

Home Address:
Parent/Gradian Name*
Parent/Guardian Email Address*

Parent/ Guardian Contact Phone*

City

State/Province

Country

PARENT/GUARDIAN INFORMATION

Parent/Guardian #1:

Parent/Gradian Name*
Parent/Guardian Address*

Email

Cell Phone

Parent/Guardian #2:

Parent/Gradian Name*
Parent/Guardian Address*

Home Phone

Mobile Phone

Email

Emergency contact

Relationship

Phone

Specify any of your child’s health problems:
Is your child on any medication?

If so, please specify:

Click here to indicate that you have read and agree to the terms presented in the
TERMS & CONDITIONS

MEDICAL FITNESS CERTIFICATE

(To be signed by a registered medical practitioner holder a degree not below that of M.B.B.S)

DOWNLOAD MEDICAL FITNESS CERTIFICATE