Payment details

Non Members $600 per person (Inc. GST) No.(...... ) United FC Members $570 per person (Inc. GST) No.(...... )

Member number (if applicable)

...... Adelaide United Captain Club Members $540 per person (Inc. GST) No.(...... ) Member number (if applicable)

......

Please tick if you require part payment option 50% at time of registration and 50% by 9/11/15

Visa/Mastercard – cheques to be made payable to Adelaide United Members Club Inc.

Card Number

Expiry Date ...... /...... CV ......

Total Amount $......

Conditions/consent Adelaide United Football Club takes no responsibility for any death, injury, damage, to any person or property occurring out of, or in consequence of, the Adelaide United Football Schools program. Should it be necessary for my child to have medical or dental treatment while attending any training session and if I cannot be contacted, permission is given for the coaching staff to use their judgement in obtaining the most appropriate treatment required. Any photographs taken during these sessions are the property of Adelaide United Football Club and can be used for promotional purposes.

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Send this registration form to: Adelaide United Football School

LAIDE PO BOX 620 Hindmarsh 5007 ADE .C. UNITED F Or go to www.adelaideunited.com.au to register online. ENROL at adelaideunited.com.au Mediterranean International Cup (MIC): Tues Wed Registration Form Session Times Central South North The MIC is going to be held at several Parent/Guardian details 15 weeks, one goal. 5.30pm- 6-8 yrs • • • football facilities along the Costa Brava in Name ...... 7.00pm 9-10 yrs • • • Girona from 22/03/2016 – 27/3/2016. Address ...... The Adelaide United Football School is 11-12 yrs • • • 6-12 yrs • • • Suburb ...... Post Code ...... back this year and it will be better than Along the 15 years of history, the MIC has Goalkeepers Phone ...... Mobile ...... ever. Based on the proven FC Barcelona seen many talents that not long after became 7.00pm- 13-14 yrs • • • philiosphy, the program has been developed professional players, playing with some of 8.30pm 15-16 yrs • • • Email ...... and will be implemented by former the most recognized teams in the world. 17-18 yrs • • • Barcelona and current Adelaide United 13-18 yrs • • • Participant details Goalkeepers coaches (Head Coach) Name ...... and Pau Marti (Assistant Coach). INCLUSIONS: Goalkeeper D.O.B ...... /...... /...... Male Female The comprehensive 15 week program is Any allergies/injuries/illness? Training kit including shirt, shorts and socks designed to teach young players the skills, ...... Small sized groups to ensure high intensity and Select venue discipline and commitment required to take quality coaching North Central South their football to the next level. Adelaide United player and coach appearances at Clothing size Kids 6 8 10 12 14 Neymar & Coutinho at MIC 2008 Football School sessions Adult S M L XL XXL In other exciting news, Adelaide United, in Specialised coaching to develop skills and a Who’s it for? progressive understanding of football conjunction with Adelaide United Members Sibling details Club Inc, will take a boy Junior Reds side to Girls and boys between 6-18 years. Each participant receives one General Admission ticket to 2 x Hyundai A-League 2015/16 Season games Name ...... compete in the Mediterranean International dates: as selected by Adelaide United Goalkeeper D.O.B ...... /...... /...... Male Female Cup (MIC) in Spain, where the Reds Youth Commencing Tuesday 13 October 2015 Attend an Adelaide United training session at Any allergies/injuries/illness? team last year achieved a spot in the One 90 minute lesson each week for 15 weeks. Coopers Stadium including a behind the scenes tour of the change rooms ...... Quarter Finals. Participants of the Football 10% discount on merchandise at club store School will not need to register for trials to locations: Clothing size Kids 6 8 10 12 14 Adult S M L XL XXL compete in MIC as players will be identified North Ridley Reserve, Fairfield Rd, Elizabeth. I wish to recieve communcations from Adelaide United FC. and introduced into the final stages of the Cost: Central Adelaide City Women’s Football Club – Registrations received after 01/10/15 may result in a delay of clothing delivery prior to 13/10/15 trial process. Positions in the squad will be Park 18, Cnr Hutt St & South Tce. $600 per person allocated to Football School participants. South Cumberland United Women’s FC – Adelaide United FC Members $570 Women’s Memorial Playing Fields, Cnr Shepherds Hill Rd & Ayliffes Rd, $540 Adelaide United Captain Club Members St Marys – enter via Shepherds Hill Rd.