2025 FV Pathway Project - Registration & Payment
Learn from international coaches
Player Information
Player Full Name
*
First Name
Last Name
Player Date of Birth
*
/
Month
/
Day
Year
Date
Current or potential eligible passport?
*
2025 Club
*
Current Playing Level
*
Preferred Position 1
*
If GK, please only fill out this preferred position box
Preferred Position 2
Emergency Contact Information
Emergency contact full name
*
First Name
Last Name
Relationship to player
*
Emergency contact email address
*
example@example.com
Emergency contact 2nd email address
*
example@example.com
Emergency contact number
*
Please enter a valid phone number.
Format: (000) 000-0000.
2nd Emergency contact number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Information
Do you consent to the use of any images/videos taken of you to be used in promotional materials?
*
Please Select
Yes
No
Does the player have any medical conditions that FV staff & coaches need to be aware of?
*
Does the player have any dietary requirements FV staff & coaches need to be aware of?
*
Does the player have any current or past injuries that may affect their performance or ability to participate in the experience? If so, please explain.
*
Is there any additional information you would like to provide us that is not already outlined in this form?
Payment
My Products
*
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Outfield Player
$600.00 AUD
$
600.00
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
Goalkeeper
$800.00 AUD
$
800.00
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
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