Register at Difathar Soccer Academy
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Academy Settings
Edit academy information fields below. Changes save automatically and update live.
Academy Name
Soccer Options (comma separated)
Separate each option with a comma
Join As Options (comma separated)
Separate each option with a comma
Experience Levels (comma separated)
Separate each option with a comma
Emergency Relationship Options (comma separated)
Separate each option with a comma
Parent Relationship Options (comma separated)
Separate each option with a comma
Default Nationality
Invoice Amount (KES)
Invoice Programme Name
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Difathar Soccer Academy
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Personal Information
Full Name
*
Letters and spaces only, min 2 characters
National ID / Passport
*
8-12 digits for ID, alphanumeric for passport
Date of Birth
*
Must be at least 10 years old
Gender
*
Select Gender
Male
Female
Other
Nationality
*
Letters and spaces only
Phone Number
*
Kenyan format: 07XXXXXXXX or 01XXXXXXXX
Email Address
*
Must be a valid email format
Alternative Phone
Kenyan format: 07XXXXXXXX or 01XXXXXXXX
Parent / Guardian Information
Add Parent/Guardian Details
(Optional)
Parent/Guardian Full Name
Letters and spaces only
Relationship
Select Relationship
Father
Mother
Guardian
Step Father
Step Mother
Grandparent
Aunt
Uncle
Older Sibling
Other
Parent/Guardian Phone
Kenyan format: 07XXXXXXXX or 01XXXXXXXX
Parent/Guardian Email
Must be a valid email format
Parent/Guardian ID Number
8-12 digits for ID, alphanumeric for passport
Parent/Guardian Occupation
Parent/Guardian Address
Residential Location
County
*
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Constituency
*
Select County First
Ward
*
Select Constituency First
Location
*
Letters, spaces, and hyphens only
Sublocation
*
Letters, spaces, and hyphens only
Village / Estate
Letters, spaces, and hyphens only
Physical Address / Directions
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Emergency Contact
Emergency Contact Name
*
Letters and spaces only
Relationship
*
Select Relationship
Parent
Guardian
Spouse
Sibling
Relative
Friend
Other
Emergency Phone
*
Kenyan format: 07XXXXXXXX or 01XXXXXXXX
Emergency Email
Must be a valid email format
Academy Information
I Want To Join As
*
Select Option
Player
Coach
Volunteer
Mentor
Staff
Other
Soccer / Area of Interest
*
Select Area
Soccer
Swimming
Counseling & Mentorship
Soccer Exchange
Team Building
Hiking
Other
Experience Level
Select Level
Beginner
Intermediate
Advanced
Previous Club / Academy
Why Do You Want To Join?
I confirm that the information I have provided is correct and I agree to participate in Difathar Soccer Academy programs and activities.
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