One Culture Football

Disability Registration Form

Please Make Sure You Fill In Both Forms Below

Registration & Player Information

Please Choose a Program *
Player Name *
Player Name
Date of Birth *
Date of Birth
Phone Number / Mobile
Address *
Medical Information
Do You Have Access to the NDIS? *
I Give Permission For One Culture Football To Use Any Photos/Videos Of Me/Player For Promotional Purposes *
Code of Conduct I will practice good sportsmanship; I will act in ways that bring respect to the players, volunteers, spectators and coaches; I will not use bad language; I will not swear and insult other people; I will not fight with other players, volunteers, spectators and coaches; I will not make inappropriate or unwanted physical or verbal advances on others. I understand that if I do not obey this Code of Conduct, I may not be allowed to participate.
Consent to Participate I give authorization to One Culture Football LTD to administer first aid or contact medical assistance if required. I hereby agree that ONE CULTURE FOOTBALL LTD and any nominated staff or volunteers shall not be deemed responsible or liable in any way for any injury or loss of personal belongings whilst engaging in a program or event. I fully understand these consents.


Parent/Guardian/Emergency Contact Details

Name *
Address (If Different to Participant's)
Address (If Different to Participant's)
Phone Number / Mobile