Player First Name
Players Last Name
Date of Birth:
Any injuries, allergies, disabilities, illnesses or relevant health concerns your coaches should know about?:
U5s - ABC (Little Eagles)U6s - Skill School (Little Eagles)U7s - George HepworthU8s - Mr Karl WellardU8s - Mr Richard KrzeminskiU9s - Mr Andy EvansU9s - Mr Ross McDaidU10s - Mr Gary MclaffertyU11s - Mr Kris McdermottU11s - Mr Jay WelshU12s - Mr Grant FlorenceU13s - Mr John BlakeU13s - Mr Ian WhartonU13s - Mr Stuart KirkU14s - Mr Mick HawthornU14s - Mr Dave LeybourneU15s - Mr Neil CoatesU16s - Mr Chris AllenLionesses - Jamie HollandGirls - U13s Lionesses
I confirm that I am the Parent or Legal Guardian of the player that I am registering with the club.
Date of Birth:
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
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.
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 firstname.lastname@example.org.
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 email@example.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.
I agree with the Terms & Conditions Click here to read Terms & Conditions.
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