LIBERIA FOOTBALL ASSOCIATION

2018-2019 NATIONAL LEAGUES COMPETITION DEPARTMENT

Passport Size Photo*

Player's License Numbers*

Name of Club*

Name of Player*

First

Middle

Last

Date of Birth*

Place of Birth*

Present Address* Your current address

Occupation*

Place of Work/School*

Have you played for any club registration with the Liberia Football Association?

Yes

If yes, which clubs(s)?

Last year played

What type of contract do you have with your present Club?*

For period of*

League Season(s)

Do hereby declare that i have consented to register with

For period of*

League Season(s)

I, player*

First

Last

Commencing

Date Submitted*

Date

Time

PLEDGE

I, the undersigned, do hereby certify that the above particulars and statements made by me are true to the best of my knowledge and belief, and that I would be liable for any false and misleading information.

Submitted by*

Club Email Address* Your email if you have

Club Phone Number*

Transfer Certificate*

If transfer from another club, please attach Transfer Certificate

Contract

Attached player contract

Medical Certificate

PLAYER REGISTRATION FORM

LIBERIA FOOTBALL ASSOCIATION

PLEDGE

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