ACADEMY APPLICATION FORM

Applicant Details:

Name

Address

Contact No E-mail

Age Sex: M / F Club that you play for

Academy Details:

Location: ............................................................... District..........................................

Time:.......................................................................

Fee monthly for 4 weeks ( 10 + players) - $ 150 inc. GST

Fee monthly for 4 weeks ( max .10 players) - $ 200 inc. GST

6 Months + 1 Month free of charge 24 + 4 * 28 SESSIONS

10 Months + 2 months free of charge 40 + 8 * 48 SESSIONS / available in 2 installments/

# Sessions have to be used within bought period also missed sessions can be used at 4 locations in Sydney#

Payment Details: BANK -Westpac/ Acc Name - Zlatko Maric / BSB 732050 / ACC 641934

AMOUNT: $ _____________________________________________

SIGNATURE: _______________________________________________

CONSENT FORM: I, the undersigned, approve of this application and in doing so do agree that the Zlatko

Maric Soccer Skills Academy are free and clear of all responsibility whatsoever for any injury or illness that

may occur during the applicants participation in the above mentioned activity.

Signature of Parent or Guardian