Consent and Registration Form | Centre of Excellence

Player's name *

First

Last

Player's date of birth *

Player's School *

Medical/Allergies (if applicable): *

Player's past football experience

Does the player play in a School team, Club team etc.?

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Parent/Guardian Name Option 1 *

First

Last

Parent/Guardian Name Option 2 *

First

Last

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Parent/Guardian Email Option 1 *

Parent/Guardian Email Option 2 *

Parent/Guardian Phone Option 1 *

Parent/Guardian Phone Option 2 *

Conduct *

I agree

1. Full IQ Football kit (top, shorts and socks) must be worn to training, and (wherever possible) at holiday clinics.

2. Training will start and finish on time so please ensure that the player arrives promptly and arrange for their pick up immediately after the completion of the session.

Enrollment and Payment *

I agree

1. All training is charged monthly regardless of attendance, with 10 monthly invoices from February to November.

2. Fees are charged monthly in advance, and are due by the 7th of the month.

3. Termination of membership shall be subject to one month’s written notice and payment thereof.

Monthly Training Fees | Age 11 – seniors *

R800 p/month – 1 session p/week
R1,200 p/month – 2 sessions p/week
R1,400 p/month – 3 sessions p/week

Please tick one relevant box

Annual Membership Fee *

I agree

Annual membership is compulsory, and is an annual once-off fee charged separately from your training fees.

Termination of membership shall be subject to one month’s written notice and payment thereof.

Please choose one of the following options by ticking the relevant box below.

Annual Membership Options *

Bronze | R650 Once-Off Payment Kit (shirt, shorts, socks)
Silver | R850 Once-Off Payment (Valued at R900) Kit + Football (Size-4)
Gold | R1100 Once-Off Payment (Valued at R1250) Kit + IQ. Ball (ball on a string)

Media and Advertising

I agree and give my permission

1. Please ‘like’ and follow our social media channels below. We wouldn’t want you to miss the official ‘announcement’ of the player joining IQ Football Academy.

Facebook: www.facebook.com/IQFootballSA
Instagram: https://www.instagram.com/iqfootballsa
Subscribe to our YouTube Channel:https://www.youtube.com/iqfootball
LinkedIn: https://www.linkedin.com/company/iqfootball

Keep up to date with all the latest developments, skills videos, and tools!

2. We would like to welcome the player as a new ‘signing’ to our IQ Football team. If you would like to be part of this celebration, please arrive 10 minutes early to your first session so that we can take a picture of the player ‘signing’ or holding up their new football kit (this is what professional football players do when they join a new team). We will also ask them these three questions:

2.1 Are they right or left footed?
2.2 Who is their favourite football player?
2.3 Why do they love football?

We will then share their picture and the answers to their questions on our social media channels to celebrate them and to announce IQ Football Academy’s newest recruit!

3. I, the parent or legal guardian of this participant, herby grant IQ Football the right and permission to use pictures, digital images, and videos of the player (in which the player may be included in whole or part) for marketing purposes.

Indemnity *

I agree and give my permission

I, the parent or legal guardian of this participant, hereby give permission for my son/daughter to participate fully in the football coaching sessions or any holiday clinics run by IQ Football. I, the undersigned, hereby agree to hold harmless and indemnify IQ Football and its coaches from any and all liability, personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever, which may be incurred by my son/daughter while they are participating.

I have read and agree to the full terms and conditions above. *

Clear Signature

Please sign here by using your curser (or finger, if you are using a touch screen). I understand and agree that electronically signing my name above is the equivalent of a written signature. Note: This form will serve as a Contract as well as indemnity. You will be emailed a copy for your reference.

Comment or Message

IQ Football Tools

IQ. Ball – R600: The IQ. Ball has been shown to improve: attention and concentration, technique, perception, coordination and timing.
IQ. Branded Size 4 Football – R250: Enabling your child to play at home gives them more opportunity to increase their ball mastery skills and confidence.

We’re always looking at ways to help ‘develop intelligent players’ – on and off the field, so we created ‘tools’ to assist in your child’s cognitive development. Should you wish to purchase one of these please indicate this above