Football Athlete Registration Form Join the Future of Football Talent Management
Personal Information:
- Full Name: _______________
- Date of Birth: _______________
- Gender: ☐ Male ☐ Female ☐ Other
- Nationality: _______________
- Contact Number: _______________
- Email Address: _______________
- Current Address: _______________
Football Profile:
- Playing Position: ☐ Goalkeeper ☐ Defender ☐ Midfielder ☐ Forward
- Preferred Foot: ☐ Right ☐ Left ☐ Both
- Current Team/Club Affiliation (if any): _______________
- League Level: ☐ Amateur ☐ Semi-Professional ☐ Professional
- Years of Experience: _______________
Physical Attributes:
- Height: _______________ cm
- Weight: _______________ kg
- Sprint Speed (if available): _______________ sec/100m
Achievements & Recognition:
- Notable Awards/Titles: _______________
- Championships/Tournaments Participated In: _______________
- Records Held (if applicable): _______________
Video & Portfolio Submission:
- Link to Highlight Reel/Gameplay Footage (if available): _______________
- Social Media/Website (if applicable): _______________
Medical & Fitness Information:
- Any Past Injuries: ☐ Yes ☐ No If Yes, Please Specify: _______________
- Current Fitness Level: ☐ Excellent ☐ Good ☐ Moderate ☐ Needs Improvement
- Medical Clearance Certificate: ☐ Attached ☐ Pending
Agency Preferences & Goals:
- Type of Representation Sought: ☐ Contract Negotiation ☐ Sponsorship Deals ☐ Career Management ☐ Marketing & Endorsement
- Short-Term Career Goal: _______________
- Long-Term Career Goal: _______________
Consent & Agreement: By submitting this form, I confirm that the information provided is accurate and truthful. I understand that submission does not guarantee representation and that further assessment may be required.
☐ I agree to the agency’s terms and conditions. ☐ I consent to my data being stored and used for evaluation purposes.
Signature: _______________ Date: _______________
Submission: Please complete this form and forward it to darm1@roehampton.ac.uk to express your interest in joining the agency.