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SPORT KLUB WINDHOEK
SKW Football Academy
SEAN Mc BRIDE STREET ■ P.O. Box 80889 ■ WINDHOEK ■ NAMIBIA
Mobile: 081 129 6930 ■ E-mail: [email protected] ■ Web page: www.skw.com.na
APPLICATION FOR SKW FOOTBALL ACADEMY
Pease complete in block letters.
_______________________________________________________________________________
Surname
Name
Date of birth
Father
Telephone (work)
Cell phone
Mother
Telephone (work)
Cell phone
Telephone(private)
E-mai:
Membership no. (if applicable)
Suburb
Street
No.
Name of hostel
Supervisor / Telephone
Telephone
Cell phone
Telephone (private)
Cell phone
Yes
Child in hostel
No

Medical problems / Allergies
Doctor to notify in emergency
Other contact person
CONDITIONS
1.
Membership Fee: (Subject to clause 4 - see overleaf)
Membership fees are payable to the SKW Football Academy before tor on 28 February 2015:
Bambini:
N$ 1300.00
u/7, u/9, u/11, u/13, u/15, u/17:
N$ 1950.00
1st team, CSL, Old Boys:
N$ 1950.00
Account Details:
Bank:
Account Type:
Account Number:
Branch Code:
Reference:
Bank Windhoek
Savings Account
2000248912
481972
Player’s initials, surname and age group
Please pay by EFT and send the proof of transfer to [email protected] . Alternatively, you can
pay by direct bank deposit and provide your coach with a copy of the deposit slip. Application forms
can be sent to the same e-mail address or handed to the coach.
www.skw.com.na - Internetform 2015
Initial:_____________
SPORT KLUB WINDHOEK
SKW Football Academy
SEAN Mc BRIDE STREET ■ P.O. Box 80889 ■ WINDHOEK ■ NAMIBIA
Mobile: 081 129 6930 ■ E-mail: [email protected] ■ Web page: www.skw.com.na
2.
Documents to be attached (for new players only))
With each application we request two certified copies of the birth certificate and two passport
photos of the player.
3.
Indemnity and Consent to Medical Treatment
I, the parent / guardian of the applicant, agree that the applicant and I will abide by the rules of the
club, its affiliated organizations and sponsors. I release, discharge and/ or otherwise indemnify the
club, its affiliated organizations and sponsors, their employees and associated personnel, including
owners of fields and facilities utilized by the club, against any claim by or on behalf of the applicant of
the applicant’s participation in the club, its competitions, tournaments and/or being transported to
and from same, which transportation I herewith authorize.
As parent or legal guardian of the above mentioned player, I hereby give consent for emergency
medical care prescribed by a duly licensed Doctor of Medicine.
4.
Youth Development Fee
In line with FIFA guidelines the SKW Football Division is entitled to development fees for players who
were previously part of the SKW Football Division.
To this end the SKW Football Division has decided on the following fee structure for the various age
groups. In each case the “Development Fee” amount is subsidized by the SKW Football Division as
long as the player remains with the SKW Football Division. The “Development Fee” becomes
refundable to the SKW Football Division on conditions set out below:
Bambini:
u/7:
u/9:
u/11:
u/13:
u/15:
CSL:
u/17:
1st team:
Total Fee
N$ 1300.00
N$ 2450.00
N$ 2550.00
N$ 2650.00
N$ 2750.00
N$ 2850.00
N$ 2950.00
N$ 3450.00
N$ 3450.00
Payable
N$ 1300.00
N$ 1950.00
N$ 1950.00
N$ 1950.00
N$ 1950.00
N$ 1950.00
N$ 1950.00
N$ 1950.00
N$ 1950.00
Development Fee
N$
0.00
N$ 500.00
N$ 600.00
N$ 700.00
N$ 800.00
N$ 900.00
N$ 1000.00
N$ 1500.00
N$ 1500.00
Any player under the age of 23 who joins a semi-professional or professional team other than SKW
will have to refund the accumulated “Development Fee” for every year which he was a member of
the SKW Football Division. Semi-professional or professional imply that the player is being rewarded
in kind or in monetary terms for his services as a football player.
Name
www.skw.com.na - Internetform 2015
Signature
Date
Initial:_____________