What we offer About your Membership Your Membership Plan Please Choose:Playing inc competitive gamesTraining Only PlanWildcatsMini Ravens Coalville Town Team Signing On: Please choose from the list below Please select teamU21 RavensU18 Ravens (Midweek)U18 Ravens MJPLU17 Ravens MJPLU17 RavensU17 RobinsU16 RavensU16 RooksU15 RavensU14 RavensU14 RooksU14 RobinsU13 RavensU13 RooksU13 RobinsU12 RavensU12 RedwingsU12 RooksU12 RobinsU12 RuffsU12 RoostersU12 Ravens (Saturday)U12 Rooks (Saturday)U12 Robins (Saturday)U11 RavensU11 RooksU11 RobinsU11 RuffsU10 RavensU10 RooksU10 RobinsU10 RuffsU10 RoostersU10 Ravens (Saturday)U10 Rooks (Saturday)U9 Ravens (Saturday)U9 RavensU9 RooksU9 RobinsU8 RavensU8 RooksU8 RobinsU8 RuffsU8 RoostersU8 RedwingsU7 Rooks (Saturday)U7 Ravens (Saturday)U7 RavensU7 RooksOpen Ladies RavenettesU18 Ravenettes (Sat)U17 RavenettesU16 RavenettesU15 RookettesU15 RavenettesU14 RavenettesU14 RookettesU13 Ravenettes (Sat)U13 RavenettesU13 RookettesU12 RavenettesU12 RookettesU11 RavenettesU11 RookettesU10 RavenettesU10 RookettesU9 RavenettesU9 RookettesU9 RobinettesU9 RuffettesU8 RavenettesU8 Rookettes Dual Signing for -U21 RavensU18 Ravens (Midweek)U18 Ravens MJPLU17 Ravens MJPLU17 RavensU17 RobinsU16 RavensU16 RooksU15 RavensU14 RavensU14 RooksU14 RobinsU13 RavensU13 RooksU13 RobinsU12 RavensU12 RedwingsU12 RooksU12 RobinsU12 RuffsU12 RoostersU12 Ravens (Saturday)U12 Rooks (Saturday)U12 Robins (Saturday)U11 RavensU11 RooksU11 RobinsU11 RuffsU10 RavensU10 RooksU10 RobinsU10 RuffsU10 RoostersU10 Ravens (Saturday)U10 Rooks (Saturday)U9 Ravens (Saturday)U9 RavensU9 RooksU9 RobinsU8 RavensU8 RooksU8 RobinsU8 RuffsU8 RoostersU8 RedwingsU7 Rooks (Saturday)U7 Ravens (Saturday)U7 RavensU7 RooksOpen Ladies RavenettesU18 Ravenettes (Sat)U17 RavenettesU16 RavenettesU15 RookettesU15 RavenettesU14 RavenettesU14 RookettesU13 Ravenettes (Sat)U13 RavenettesU13 RookettesU12 RavenettesU12 RookettesU11 RavenettesU11 RookettesU10 RavenettesU10 RookettesU9 RavenettesU9 RookettesU9 RobinettesU9 RuffettesU8 RavenettesU8 Rookettes About the Player Players Name (required) Players DOB (required) Contact Number (required) Player First Line Address 1 Owen Street (required) Player 2nd Line Address Coalville (required) Player Post Code LE67 3DA(required) Parent/Primary Email Address (will be used for payment details) Player Email Address (required if 16 or over) Has the player played competitive football for Coalville Town Youth FC in the previous season? YesNo Player ID Only required if the player has not previously played competitive football for Coalville Town Youth FC please upload either passport/birth certificate How did you hear about Coalville Town Football Club Player Photo Digital Photos must not; contain no other objects or people be taken against a plain light-colored background be in clear contrast to the background not have ‘red eye’ If you’re using a photo taken during your application, including your head, shoulders, and upper body. Please do not use HD settings on iPhone, as this may cause issues submitting your form 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 player 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 Payment Plan Details How you wish to pay -Direct DebitLump Sum Direct DebitPay As You Play Monthly Direct Debit Fee : £28.00 Monthly Direct Debit Fee if Player Plays for Two Teams £40.00 Season Lump Sum for one team : £252.00 Season Lump Sum for two teams : £360.00 Preferred Direct Debit Date -1st Month15th Month NOTE NOTE THIS RUNS FROM SEPTEMBER TO MAY NOTE For players over 16 that are injured, NO direct debit cancellation unless advised by Club Physio NO PLAYER SHALL BE REGISTERED IF ANY OUSTANDING FINES OR DEBTS FROM LAST SEASON ARE OUTSTANDING. 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 Account No 36867562 Training Only Plan Type Cost Monthly Direct Debit Fee (1st of each month) £16.00 per month over 9 months Mini Ravensl Direct Debit Type Cost Monthly Direct Debit Fee (7th of each month) £15.00 Mini Ravens Pay as you play 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 Payments If you are an existing member and wish to continue using the same direct debit mandate this season no action is required If you are an existing member and wish for your direct debit mandate to change - please email CTFC.payments@gmail.com If you are a NEW member, you will be receiving a email request setting up of a CTFC Direct Debit via Go Cardless If payment terms are less than the 10 days prior to collection , then a separate payment will be required for first month. Should you have any queries or issues please contact our membership team by emailing us at ctfc.membership@gmail.com 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 .