Club Registration 2021 / 2022 Season

Player Details:

Player First Name

Players Last Name

Date of Birth:
Attending School

Medical Conditions:

Any injuries, allergies, disabilities, illnesses or relevant health concerns your coaches should know about?:

Please Select Team & Manager:

U5s - ABC (Little Eagles)U6s - Skill School (Little Eagles)U7s - New ManagerU8s - George HepworthU8s - Shaun WilkinsonU9s - Karl WellardU9s - Mark TownendU9s - Richard KrzeminiskiU10s - Ross McdaidU10s - Andy EvansU11s - Gary MclaffertyU12s - Kris McdermottU12s - Andy CroftU12s - Paul WestonU13s - Grant FlorenceU14s - Ian WhartonU14s - John BlakeU14s - Stuart KirkU15s - Mick HawthornU15s - Dave LeybourneU16s - Neil CoatesU17s - Chris AllenGirls - U14s Lionesses - Stuart O'Neil

Parents / Gurdians Details:

I confirm that I am the Parent or Legal Guardian of the player that I am registering with the club.

Date of Birth:

Medical Consent:

Yes, I agree to my son/daughter if injured whilst playing football or travelling to and from football Events to receive medical attention if I cannot be contacted on the above number, I hereby consent for my child to receive medical attention

In the Event That the Above Named Parent/Guardian Cannot be Reached, Please Give an Emergency Contact Name and Telephone Number

The Taking and Use of Photos/Videos:

Yes, I agree to allow my child/children to be photographed/videoed during training or matches and for the club to use the images ( e.g. website) providing it is done in line with the FA guidelinesNo, I do not consent to my child /children being photographed or videoed - if selected you must tell the coach as soon as possible.

The Club's Data Storage, Usage and Access Policies and Your Rights (GDPR):

I give permission for the club to send me information from carefully selected organisations. I realise that the club will not pass on my details to any organisation and that I can withdraw this permission at any time by informing the club via an email to eldwickjuniors@gmail.com.
The Eldwick Juniors committee, coaches and squad helpers can see, edit or use your membership data. We will use the data you provide to help us identify you and your child/children as members of the club and your squad and to send you information about club and squad matters. We do not see or hold any credit/debit card or bank details. If you are concerned or know about your data being used inappropriately please inform us immediately by telling a coach or emailing us on eldwickjuniors@gmail.com. If we identify or are informed about a breach of data rules or our policies, we will get in touch with you and report it to the appropriate authorities within 72 hours.

Membership Agreement (Terms & Conditions):

• I agree to abide by the Club's Parents/Guardians' Code of Conduct and will ensure that my son/daughter will abide by the Club's Players Agreement.
• I agree not to publicly criticise or abuse match officials, coaches, managers, or players of Eldwick Juniors and other clubs. I am aware that if I break the code of conduct that my son/daughter may be required to leave the club.
• I agree that I, or a responsible person nominated by me, will remain with my child/children and will be responsible for them during matches and training

I agree with the Terms & Conditions Click here to read Terms & Conditions.

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