Training Member Only Member Forms – Coalville Town Youth Football Club

COALVILLE TOWN YOUTH TRAINING MEMBER ONLY

Player Details

Player Name (required)

Player DOB (required)

Player Nationality (required)

Player Country of Birth (required)

Player Address (required)

Player Address Post Code (required)

Coalville Town Team Signing On:

Parent/Guardian Details/Emergency Contact Details

Parent/Guardian Details/Emergency First Name (required)

Parent/Guardian Details/Emergency Surname Name (required)

Parent/Guardian Details/Emergency Phone No. (required)

Parent/Guardian Details/Emergency Email Address (required)

Second Emergency Contact Name (required)

Second Emergency Contact No (required)

Second Emergency Relationship to Player (required)

Medical Conditions Details

Does the player signing on have any medical conditions ?(required)
YesNo
if Yes, please fill in below details;
Medical Condition;

Doctors Name (required if Yes)

Doctors Address (required if Yes)

Doctors Phone No (required if Yes)

PLEASE READ

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 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).

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

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

Read & Understood

If mine/parent/guardian behaviour causes the club to incur fines then you will 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

Payment

Type	Cost
Monthly Direct Debit Fee (1st of each month)	£12.00

I confirm that the information given in this form is true, complete and accurate.

Please check your details are correct before submitting this form. Any missing information will hold up registration of player