433 Football Academy — International Player Registration

1. Personal Information

Full Name

Date of Birth

Gender

Nationality

Country of Birth

Country of Residence

Phone Number

Email Address

2. Passport & Visa

Passport Number (optional)

Passport Expiry (optional)

Do you have a UK Visa?

Yes No Applied / In Progress

Visa Type (if applicable)

Visa Expiry (if applicable)

3. Parent / Guardian & Emergency Contact

Parent / Guardian Full Name

Parent / Guardian Phone

Parent Email (optional)

Relationship to Player

Emergency Contact Name (if different)

Emergency Contact Phone (if different)

Agent Name (if applicable)

Agent Phone (if applicable)

4. Education

School / College Name (optional)

Level of Education

Currently Enrolled?

Yes No

Travelling situation

Leaving education to travel Coming during holiday / break Not applicable

Certificates / Qualifications (optional)

5. Current Club

Currently registered with a club?

Yes No

Club Name (if applicable)

Club Country (optional)

League / Division (optional)

Playing Position

Preferred Foot

6. Football History

Previous Clubs (optional)

International Caps (optional)

Achievements / Awards (optional)

Video / Highlights Link (optional)

Why do you want to join 433 Football Academy?

7. How You Found Us

How did you hear about 433 Football Academy?

Social Media (Instagram / Facebook / TikTok) Google Search Referral from a friend or family Referred by a coach or club Agent referral Event or tournament Other

Referred by (name) (optional)

8. Housing Pack

433 Football Academy offers accommodation packages for international players. Please select the duration you require.

Accommodation Duration

1 Month 3 Months 6 Months 1 Year 2 Years Not required / I have my own accommodation

Expected Arrival Date (optional)

Housing Notes (optional)

9. Medical Information

Any medical conditions?

Yes No

Medical Details (if applicable)

Any allergies?

Yes No

Allergy Details (if applicable)

Currently taking medication?

Yes No

Medication Details (if applicable)

Any previous injuries?

Yes No

Injury Details (if applicable)

10. Courses & Extras

Select any additional development courses you are interested in.

Additional Courses

English Language Classes Sports Science & Nutrition Coaching Licence (UEFA) Strength & Conditioning Mental Performance Coaching Academic Support / Tutoring Football training only

Other Interests (optional)

11. Media Consent

433 Football Academy may take photos and videos during training, matches, and events for promotional and social media use.

Do you consent to photos / videos being used by 433 Football Academy?

Yes — full consent Yes — training only (not social media) No — I do not consent

Parent/guardian consent (if player is under 18)

Yes No Not applicable — player is 18 or over

Media Notes (optional)

12. Declaration

Please read and confirm the following before submitting.

I confirm all information provided is accurate and complete to the best of my knowledge. I understand 433 Football Academy will use my personal data in accordance with their Privacy Policy and GDPR regulations. I agree to abide by the rules, code of conduct, and policies of 433 Football Academy. I understand submitting this form does not guarantee a place at the academy.

Full Name (as signature)

Date

Additional Notes (optional)

✓

Application Submitted!

Thank you for registering with 433 Football Academy. We have received your application and will be in touch with you shortly. We look forward to hearing more about you!

433 Football Academy
Roe Lane Playing Fields, Newcastle-under-Lyme, ST5 3PH
fatiha@433football.net