Juventus Academy Los Angeles

Parent/Guardian Information

Name

Phone Number

Address

Program Option

Name

Gender

Date of Birth

T-Shirt Size

Medical Conditions

Allergies

Player's Preferred Position

Player's Last Club(s)

Registering Second Child?

Name

Phone Number

Relation to Player(s)

Mandatory Waiver Form

I, the undersigned, agree to the terms above.

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