Wildcats Member Form About your Membership Your Membership Plan About the Player Players Name (required) Players DOB (required) Player Post Code Current School Year Contact Number (required) Parent Name (required) Parent/Primary Email Address (will be used for payment details) How did you hear about Coalville Town Football Club Next Emergency Details and Medical Details 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) Medical Details Does the child signing on have any medical conditions that you believe we should be aware of that may affect the player during training or matches YesNo Doctor Details Doctors Name Doctors Address Doctors Phone No Welfare Is there any family Members you wish NOT collect your child (required) YesNo Any impairments - that we need to be made aware of (learning/hearing difficulties) YesNo Any relevant information about their culture or faith that we need to be aware of. YesNo BackNext Wildcats Pay as you play Pay as you play £4.00 per session Payment made on attendance BackNext Membership Terms and Conditions - Read and Understand View Code of Conduct 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 Read and Understood 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 Playing for a team We expect your commitment to let your manager know if your child cannot attend training or will not be available for any games (giving as much prior notice as possible). If mine/parent/guardian behaviour causes the club to incur fines then you will be deemed liable for the associated costs. Any outstanding debts/fines may cause the player to be inegliable to play for the team until such time debts/fines have been cleared. Read & Understood ---YesNo . Back