Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Player & Academic Information – Step 1 of 5PLAYER INFORMATIONFull Legal Name *Preferred Name / NicknameDate of Birth *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AgeGenderMaleFemaleOtherNationalityCountry of Birth Address *Address Line 1CityState / Province / RegionPostal Code— Select country —AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPassport NumberACADEMIC INFORMATIONCurrent School NameCurrent Grade / Level Highest Grade Completed Preferred Academic TrackLocal CurriculumOnline / Hybrid LearningOtherNext: Soccer ProfileSOCCER PROFILEPrimary Playing Position GoalkeeperDefenderCenterMidfielderForwardDominant Foot RightLeftBothCurrent / Most Recent Club Years of Competitive ExperiencePlaying Background Club SoccerAcademy SoccerSchool SoccerRegional LevelNational Team PoolProfessional AcademyNotable Achievements / Honors PHYSICAL & MEDICAL INFORMATIONHeight (cm) Weight (kg) Medical Conditions / AllergiesCurrent Medications Dietary Requirements NoneVegetarianVeganHalalKosherOtherBackNext: Residential DetailsRESIDENTIAL PROGRAM DETAILSRequested Entry Date *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Program Duration *MonthlyTerm / SemesterFull YearPrevious Boarding Experience? *YesNoIf yes, please explainPARENT / GUARDIAN INFORMATIONParent / Guardian Full Name *Relationship to PlayerPhone *Email Address *Home AddressEMERGENCY CONTACTEmergency Contact NameRelationshipEmergency Phone Number *Emergency EmailBackNext: Documents & PaymentDOCUMENT UPLOADSPlayer CV / Soccer Resume (PDF) Click or drag a file to this area to upload. Highlight Video LinkAcademic Records Click or drag a file to this area to upload. (PDF / Image)Copy of ID / Passport Click or drag a file to this area to upload. (PDF / Image)Player Passport Photograph Click or drag a file to this area to upload. (Image Upload)BackSubmit Application & Pay NowFEES & ONLINE PAYMENTRegistration Type * Enrolment Only – R300 (Once-off) Registration/Enrollment Fee – R900 On-Campus Residential Fee – R3,500 AGREEMENTS & CONSENTSProgram Commitment & Code of Conduct *I agree to abide by academy rules, discipline, and conduct policiesMedical & Liability Waiver *I acknowledge and accept the medical and liability termsPhoto & Media Consent YesNoACCOUNT CREATIONName *FirstLastUsernameEmail *Password *PasswordConfirm PasswordSubmit Application & Pay Now
