Real Betis Academy International Bhubaneswar

Real Betis Camp Bhubaneswar, India

dates

Course 17/10 - 21/10

for who?

boys and girls

ages

10 - 18 years

location

Bhubaneswar, India

Jayadev Mahapatra

phone

(+91) 9937311119

Instagram: ardorfootballacademy

register

DETAILS OF THE MOTHER, FATHER OR GUARDIAN

Name

First Surname

Second Surname

DNI

Phone

Mobile phone

AUTHORIZED PERSONS

Name

First Surname

Second Surname

DNI

Emergency contact name

Emergency contact telephone number

PLAYER DETAILS

Name

First Surname

Second Surname

date of birth

Province

Do you suffer from any illness?

Yes No

Specify medical conditions

Do you suffer from any allergies?

Yes No

Specify allergies

Do you play for any team?

Yes No

Are you federated?

Yes No

Medical care

Social Security Private Insurance

No. Social security

No. Private insurance

How did you find out about the campus?

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*you must read and accept the legal notices and privacy policy.

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