Player Registration

Secure Your

Spot at CCISA

Complete the registration form below to officially enroll your player in the CCISA program. Availability is limited — spots are filled on a rolling basis.

Ages 8–19UEFA-Inspired CoachingBarcelona Elite PathwaySabal Pines Park, Coconut Creek

Player Information

First Name*

Last Name*

Date of Birth*

Age Group / Program*

School / Grade

Nationality

Parent / Guardian Information

Parent / Guardian Name*

Relationship to Player*

Email Address*

Phone Number*

Home Address

City / State / ZIP

Soccer Experience

Years Playing Soccer

Current / Previous Club

Primary Position

Dominant Foot

Soccer Background / Achievements

Program Selection

Program of Interest*

Season Start

How Did You Hear About CCISA?

Goals for Your Player

Medical Information

Known Allergies

Current Medications

Medical Conditions / Injuries

Emergency Contact Name*

Emergency Contact Phone*

Agreements & Consent

I understand that participation in soccer involves physical activity and inherent risk. I consent to my player's participation in CCISA training and competition activities.I grant CCISA permission to use photographs and videos of my player for academy promotional materials, social media, and website content.In the event of a medical emergency, I authorize CCISA staff to seek appropriate medical treatment for my player if I cannot be reached.I have read and agree to uphold the CCISA Code of Conduct for players, parents, and guardians.

Parent / Guardian Signature (Full Name)*

Date*

Additional Notes or Questions

Registration Fee Payment

Required to complete your player's enrollment

To complete your player's registration, please submit the required registration fee using the secure payment method below. Once your payment has been received, return to this page and complete the registration form.

Official Zelle Payment

Official CCISA Zelle QR Code — scan to pay registration fee

Official CCISA Zelle PaymentRegistration Fee: $200.00

Registration Fee$200.00

Zelle RecipientCoconut Creek International Soccer Academy

Payment Instructions

In the Zelle memo, enter the Player's First and Last Name.

Scan the QR code.

Send $200.00 via Zelle.

Include the Player's First and Last Name in the Zelle memo.

Enter the Zelle Confirmation Number below.

Upload the payment confirmation.

Questions about your payment? Contact us at (954) 899-8600 before submitting your registration.

Zelle Confirmation Number / Transaction ID*

Upload Payment Confirmation*

Accepted formats: JPG, PNG, PDF · Screenshot or photo of your Zelle payment confirmation

Your payment confirmation and registration information are securely received by Coconut Creek International Soccer Academy and used only to process your player's enrollment.

By submitting this form you confirm all information is accurate. A CCISA staff member will contact you within 3–5 business days.

Registration Includes

Player evaluation & placement

Year-round structured training

UEFA-inspired coaching curriculum

Competition team placement

Player development tracking

Barcelona Elite Pathway eligibility

Questions? Contact Us

[email protected](954) 899 8600

First Time Here?

Learn about our programs and the admissions process before registering.

View the Apply Page