PLAYER REGISTRATION FORM:
(Founded 1979)
CLUB MOTTO 'TO WIN FAIRLY - TO LOSE WITH HONOUR'

FULL NAME OF PLAYER:
HOME ADDRESS:
POST CODE:
HOME TELEPHONE NUMBER:
DATE OF BIRTH:
NATIONALITY:
SCHOOL:
SCHOOL YEAR:
MEDICAL DETAILS: (Please indicate any medical problem the player has which the Club should be aware of e.g. asthma)


PARENTAL/GUARDIAN DETAILS:
FIRST NAME:
SURNAME:
TELEPHONE NUMBER:
MOBILE:
In the event that the above named person cannot be reached please give an extra contact name
and number
NAME EMERGENCY CONTACT NO.
PARENTAL CONSENT:
Should my son/daughter be injured whilst playing football/travelling to and from football events and I cannot be contacted on the above numbers, I hereby give my consent for my child to receive medical aid.
SIGNED:

DATE:

PRINT NAME (PARENT / GUARDIAN):

I agree to be bound by the Club Rules F.A Rules and Competition Rules which the Club may
take part in.
I agree to pay the current membership fee if this application is accepted.

SIGNED AND DATE: