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Athlete Request
Professional player registration:
*
Indicates required field
Name (first, last):
*
First
Last
Please Upload a Current (headshot) Image of yourself:
Upload File
*
Max file size: 20MB
Please update a headshot from your Club/Team. If you do not have this. Please take a clear headshot with a solid background (like a wall) behind you. Wearing a solid white tshirt or polo shirt with no logos, image on it.
Date of Birth
*
Current Age
*
Nationality
*
Passport(s)
*
Please list all passport(s) that are current and not expired.
Parent(s) Name(s) - (if under 18years old):
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Primary Phone Number
*
Mobile Phone Number
*
WhatsAPP Number
*
If you do not have a WhatsAPP number, within the box below put (NA).
Skype
*
If you do not have a skype account, within the box below put (NA).
Facebook
*
If you do not have a facebook account, within the box below put (NA).
Highlight Link 1:
*
Please copy/paste a full match or match highlight link within the box below. This could be used for evaluation purposes so please make sure it is clear who/where you are playing on the field. As well as make sure the quality of the video is of the standard a scout could use to make a determination of your abilities.
Twitter Handle (@):
*
If you do not have a twitter handle, within the box below put (NA).
Highlight Link 2:
*
Please copy/paste a full match or match highlight link within the box below. This could be used for evaluation purposes so please make sure it is clear who/where you are playing on the field. As well as make sure the quality of the video is of the standard a scout could use to make a determination of your abilities.
Instagram
*
If you do not have an instagram account, within the box below put (NA).
Highlight Link 3:
*
Please copy/paste a full match or match highlight link within the box below. This could be used for evaluation purposes so please make sure it is clear who/where you are playing on the field. As well as make sure the quality of the video is of the standard a scout could use to make a determination of your abilities.
Additional Personal INFO:
*
Please place any additional personal info you would like to be posted to your profile.
Primary Position:
*
Forward (Striker or Winger)
Midfield (Central)
Midfield (Wide)
Defender (Central)
Defender (Full or Wing Back)
GoalKeeper
Height (provide in inches):
*
Second Position:
*
Forward (Striker or Winger)
Midfield (Central)
Midfield (Wide)
Defender (Central)
Defender (Full or Wing Back)
GoalKeeper
Weight (provide in pounds):
*
Dominant Foot
*
Left
Right
(Current) Body Fat %:
*
Only list an actual body fat % if it has been tested by a club/team or medical professional.
Do you currently have Representation:
*
Yes
No
Only by an Intermediary (not an agent)
Representation would constitute as any signed agreement with an agency, licensed FIFA agent. Or if an agreement with an intermediary, would constitute as any agreement written or unwritten where an individual would be owed a rights fee should you sign/transfer to a new club/team.
Agent/Intermediary Email:
*
If you do not have an agent or intermediary please put (NA) in the spaces below.
Agent/Intermediary Name (first, last):
*
First
Last
If you do not have an agent or intermediary please put (NA) in the spaces below.
Agent/Intermediary (Country):
*
If you do not have an agent or intermediary please put (NA) in the spaces below.
Agent/Intermediary Phone Number:
*
If you do not have an agent or intermediary please put (NA) in the spaces below.
Agent/Intermediary (License#):
*
If you do not have an agent or intermediary please put (NA) in the spaces below.
CURRENT (Club or Team):
*
CURRENT Coaches Name:
*
CURRENT (League and Age Group):
*
CURRENT Coaches Email:
*
My first year with this (Club/Team):
*
Current Coaches Phone Number:
*
Are you currently under contract w/ this (Club/Team):
*
Yes
Yes, but they are willing to give me a FREE relsease
No
DATE (current or previous) contract expired or expires:
*
Past (Club/Team) 1:
*
Past (Club/Team) Coaches Name 1:
*
Past (League/Age Group) 1:
*
Past Coach Email (Club/Team) 1:
*
My LAST year at this (Club/Team) 1 was:
*
Past (Club/Team) 2:
*
Past (Club/Team) Coaches Name 2:
*
Past (League / Age Group) 2:
*
Past Coach Email (Club/Team) 2:
*
My LAST year at this (Club/Team) 2 was:
*
Additional Playing INFO:
*
Please place any additional playing info (player info, club/team, injury) etc., you would like to be posted to your profile.
I agree to receiving marketing and promotional materials
Submit
Home
ABOUT US
Leadership
MEDIA
Community
IMPACT
Playbook Programs
Contact
Event Registration
CU-BSE
Athlete Request