Mini Ravens/Wildcats Membership

    About your Membership

    About the Player

    Players Name (required)

    Players DOB (required)

    Parent/Guardian Name

    Parent/Guardian Number (required)

    Parent/Guardian Address (required)

    Parent/Guardian Post Code (required)

    Parent/Guardian Email Address (required)


    Emergency Contact Details

    1st Emergency Contact Name (required)

    1st Emergency Contact Phone Number (required)

    2nd Emergency Contact Contact Name (required)

    2nd Emergency Contact Phone Number (required)

    Does the player signing on have any medical conditions that you believe we should be aware of that may affect the player during training ?



    Payment Plan Details

    How you wish to pay

    Wildcats Direct Debit

    Type Cost
    Monthly Direct Debit Fee (7th of each month) £15.00

    Wildcats Pay as you Play

    £4.00 per session payable by direct transfer to

    Pay as you Play Payment Details
    Coalville Town Youth Football club
    Sort Code 30 98 97
    36867562

    Mini Ravens Direct Debit

    Type Cost
    Monthly Direct Debit Fee (7th of each month) £15.00

    Mini Ravens Pay as you Play

    £4.00 per session payable by direct transfer to

    Pay as you Play Payment Details
    Coalville Town Youth Football club
    Sort Code 30 98 97
    36867562


    Membership Terms and Conditions - Read and Understand

    I have read and understood the FA Respect Code of Conduct for Young Players, Spectators/Parents/Carers, and the policies of the club and I will follow the Code of Conduct and Club policies at all times. If I do not follow the Code of Conduct and Club policies, I am aware of the possible actions by Coalville Town and the FA

    Marketing

    Photographs may be taken of your child playing for Coalville Town Youth FC,
    Please tick if this is acceptable as we may use these photographs for publicity and promoting the club.

    YesNo

    We love to send you details about up and coming events,offers and the latest info from Coalville Town Youth Football Club by email, SMS and other electronic means. We'll always treat your personal details with the upmost care and never sell them on to other companies for marketing purposes.

    Yes - PleaseNo - Thanks