Registration Form 2022 2023 for NEW Player

the registration form and the required documents are obligatory to be Registered to the club/le formulaire d’inscription et les documents requis sont obligatoires pour être inscrits au club

Rue Arthur Maes, 1
1130 Haren (Brussels)

jacademyhq@gmail.com
+32 471 593241

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Player Name

Player Last Name

Player Date of birth

Player Birth date

Player Birth place & ZIP code

Gender(required)

M F

Current Belgium Street Address

Current Belgium City & ZIP code

PRE-Belgium address

PRE-Belgium City & ZIP code

Country

FAMILY STATUS

Father name & last name

Father date of birth

Mother name & last name

Mother date of birth

Chidren name & date of birth

FOOTBALL EXPERIENCE

Previous Club

Years played

Role/Position

GK D M F

Personal Contact

Email address

2nd Email Address

Phone

2nd Telephone

DOCUMENTS REQUIRED
ID-Card/Passport copy
Medical Certificate

Juventus Academy HQ Brussels

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