ADMISSIONS APPLICATION FORM
Name:
Address:
Phone:
Date of Birth:
Level of Education (Primary,Secondary,University)
Sex: Email:
School:
Please select all that apply
Forward Midfielder Defender Goal Keeper
Category:
U5 U8 U11 U13 U15 U17 U19
Name of Parent/Guardian:
Home Phone: T-Shirt Size XS S M L XL
Terms and Conditions:
The parents must ensure the participant is healthy and physically fit, able to participate in sports activities.
Accordingly, you accept all risk resulting from participating in AS. Roma Academy, Training and matches.
The Club\Academy is not responsible for any accidental injury, loss, damage or death during or aer the activity.
The cost of damage cause by the participant in AS. Roma Academy will be passed onto the parents or care giver
All courses, activities and training can be changed prior to notice.
You agree to grant AS. Roma and the academy the right without a composition to use the participants name, photographs, video or
likeness for our commercial and media purposes such as our website, newspaper ads and social media
All participant should be required to submit their passport plus 1 passport sized photo.
AS. Roma Academy does not bear any responsibility for any child outside of the filed aer or before the training time
The payment can be done by CREDIT CARD, CHEQUE AND/OR BANK TRANSFER
Payments and Refunds:
The payment can be done by CREDIT CARD, CHEQUE AND/OR BANK TRANSFER
Parent Signature
Any registration will be valid and confirmed only aer payment
In case the participant cannot attend the training for any personal reason, the missing
session will not be made up and the payment are not refundable
The parents are NOT ALLOWED TO STAY ON THE PITCH during the activities
Date
Play and learn in AS.ROMA style
ADMISSIONS APPLICATION FORM
HOW TO REGISTER
Complete the Registration Form, you may fill it online or
print it manually and filled in BlOCK LETTERS.
PRINT, & SIGN once you finish completing the registration form.
PAY the initial deposit
A deposit of #1,000,000 or $1,500 is requested to confirm the registration.
This amount will be deducted from the final estimated fees on the invoice.
SEND us the Registration Form and Initial Deposit‘s receipt.
The Registration Form and copy of the Initial Deposit‘s receipt
must be sent to us via email: abujaacademy@asroma.it
FINAL PAYMENT
The final payment must be sent within 30 days of the start of the
term by bank transfer to:
AS Roma Academy Abuja
Zenith Bank Plc
1217552076.
