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

Player Name(required)

Player Last Name(required)

Player Date of birth(required)

Player Birth date (required)

Player Birth place & ZIP code(required)

Gender(required)

M F

Current Belgium Street Address(required)

Current Belgium City & ZIP code(required)

PRE-Belgium address(required)

PRE-Belgium City & ZIP code(required)

Country(required)

FAMILY STATUS

Father name & last name(required)

Father date of birth(required)

Mother name & last name(required)

Mother date of birth(required)

Chidren name & date of birth

FOOTBALL EXPERIENCE

Previous Club

Years played

Role/Position

GK D M F

Personal Contact

Email address(required)

2nd Email Address

Phone(required)

2nd Telephone

DOCUMENTS REQUIRED
ID-Card/Passport copy
Medical Certificate

Juventus Academy HQ Brussels

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