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Get Safa Player Registration Form

Any Official of SAFA Ethekwini or Association to obtain any information regarding the player from the school or any other authority 2. Attach in this space 1st Photo on original reg 2nd Photo on duplicate reg 3rd Photo on certified ID Staple all pages together at top-left corner SAFA ETHEKWINI REGION JUNIOR PLAYERS INITIAL REGISTRATION FORM 2012 SEASON THIS FORM IS TO BE COMPLETED IN DUPLICATE PLAYER S DETAILS NAME OF PLAYER FIRST NAME/S POSTAL ADDRESS RESIDENTIAL ADDRESS HOME TELEPHONE NUMBER BUSINESS TELEPHONE NUMBER DATE OF BIRTH IDENTITY NUMBER OF PLAYER PARENT / GUARDIAN S DETAILS NAME AND SURNAME CELLULAR NUMBER EMAIL ADDRESS I Parent/Guardian of the said player hereby give consent for 1. The said player to participate for the Club and the Association Signature of Parent/Guardian Date / / 2012 CLUBS DETAILS NAME OF CLUB ESCOMBE FOOTBALL CLUB SECRETARY OF CLUB ADDRESS OF CLUB TELEPHONE NUMBER PREVIOUS CLUB SIGNATURE OF SECRETARY DIVISION Kathy van der Vlies Bowker Road Escombe HOME - N/A WORK/CELL 0826521117 DISTRICT E-MAIL kathy afroprop*co. za YEAR 2011 SCHOOL S INFORMATION Check photograph against player before signing / stamping Stamp across the photo and registration form at the top right-hand corner NAME OF SCHOOL ADDRESS OF SCHOOL SIGNATURE OF OFFICIAL DISTRICT ASSOCIATION DATE RECEIVED LFA STAMP RECORD CLERK GRADE TELEPHONE DESIGNATION FOR OFFICIAL USE REGIONAL STAMP NOTE Three photos passport size all identical and ID Copy certified attached* UNDER. The said player to participate for the Club and the Association Signature of Parent/Guardian Date / / 2012 CLUBS DETAILS NAME OF CLUB ESCOMBE FOOTBALL CLUB SECRETARY OF CLUB ADDRESS OF CLUB TELEPHONE NUMBER PREVIOUS CLUB SIGNATURE OF SECRETARY DIVISION Kathy van der Vlies Bowker Road Escombe HOME - N/A WORK/CELL 0826521117 DISTRICT E-MAIL kathy afroprop*co. za YEAR 2011 SCHOOL S INFORMATION Check photograph against player before signing / stamping Stamp across the photo and registration form at the top right-hand corner NAME OF SCHOOL ADDRESS OF SCHOOL SIGNATURE OF OFFICIAL DISTRICT ASSOCIATION DATE RECEIVED LFA STAMP RECORD CLERK GRADE TELEPHONE DESIGNATION FOR OFFICIAL USE REGIONAL STAMP NOTE Three photos passport size all identical and ID Copy certified attached* UNDER..

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