Registration - Junior

Junior Registration

Important!

Please note that we will be in contact to confirm acceptance of registration. Once confirmed, a payment is required in order to complete the application. Clearance certificates are required if players belonged to a prior club.

Player Registration - Juniors

Player's First Name

Player's Last Name

Primary Contact for Player

First Name

Last Name

Relationship to Player

Contact Email

Contact Phone Number

New or Returning Player

New Player

Returning Player

Players ID number

Players Age in 2026

Address

Address Line 1

Address Line 2

City

Area Code

Current School

Current Grade

Player T-Shirt Size

Medical Conditions / Allergies

Players Photo

Select File

Players Birth certificate

Select File

Players Clearance Letter

Select File

Note: Well taken cellphone photos are acceptable for the above. Please ensure that the lighting and framing of the document is adequate so as to produce a good clear image.

FAMILY DETAILS

Please fill in as required

Mothers Full Name

Mothers Email Address

Mothers Mobile

Fathers Full Name

Fathers Email Address

Fathers Mobile

Guardians Name

Guardians Email Address

Guardians Mobile

Are you able to assist in future fund raising efforts?

Yes

Please detail how you would like to assist the club

FEE STRUCTURE AND INDEMNITY

FEE STRUCTURE:

Annual fee: R3750

EARLY BIRD - Paid in full by 31 Dec 2025, R3500 Total

EARLY FLEXI - ⁠Paid Dec (R1750) & Jan (R1900) = R3650

3 Month - ⁠Jan (R1250), Feb (R1250) & Mar (R1250) = R3750 Total

All fees must be paid before the start of league

Should subscription fees not be paid in full by the start of the league, the player's card will be held i.e. no pay no play. Please use the players name, surname, and age group this year as a reference when paying by EFT, e.g. U7 – Olwethu Gumede

INDEMNITY

By submitting this form, I confirm that I have read and understood the RULES and CONDITIONS and agree to abide by the same at all times. Notwithstanding these undertakings, I fully absolve Origin Football Club, club officials, referees, coaches and/or voluntary assistants from any liability, injury, loss or damage to persons or property arising from accidents and/or incidents occurring during, or associated with any activity including coaching sessions, matches, travel to and from said activities or any other related activity. I also agree to pay all club fees when due and return any kit that remains the property of Origin Football Club at the end of the season. I have read and agree as a parent/guardian that I will enforce and abide by the Origin FC Code of Conduct without prejudice. I accept responsibility for my child’s and my behavior concerning said rules and conduct.

POPI INFORMATION

“This form contains personal information as defined in the Protection of Personal Information Act, 2013 (the “Act”). By signing this form, the signatories consent to the processing of his/her personal information in accordance with the requirements of the Act. Consent cannot unreasonably be withheld. The purpose for collecting the personal information of the signatories contained in this form, is for Registration purposes in the ELFA League.”

PHOTO & VIDEO PUBLISHING CONSENT

By submitting the form I give Origin FC permission to take photographs and / or video of my child. I grant Origin FC full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group’s aims. This might include (but is not limited to), the right to use them in their printed and online publicity, social media, press releases and funding applications.

I have read and agree as stated