Registration Request - FOOTS UK FC

Player Details

First Name *

Last Name *

Date of Birth *

Gender *

School *

School Year *

Enter number

I am... *

What is your favourite position? *

Parent or Guardian Details

Parent/Guardian First Name *

Parent/Guardian Last Name *

Please specify your relationship to the player *

Address *

Address

City

Post Code

Country

Email *

Home Phone

Mobile *

Country of Origin

Country

Religion (if any)

Medical Information

Do you describe the player as having any disability? *

If Yes, how would you describe this? (e.g. physical disability, hearing impairment, visually impaired, etc)

Do you describe the player as having any learning difficulties? *

Does the player have any medical conditions (e.g. Allergies, Asthma, Diabetes, Epilepsy, etc) *

If yes, please describe this medical condition(s)

Consent

Please read carefully and tick: *

I consent to the use of photo/video/social media containing my/my child’s image in any material related to FOOTS UK publicity or administration purposes
I consent to my child taking part in all of the activities of the Organisation unless I state otherwise
I consent to FOOTS UK passing my information to carefully selected third party so that I can receive relevant information regarding events and projects
I consent to FOOTS UK communicating with me/my child through social media/text/emails etc

FA Respect Code of Conduct

PLEASE READ: Foots UK Code of Conduct for Youth

PLEASE READ: Foots UK Code of Conduct for Adults in Youth Football

Declaration

Please read the below declaration carefully and tick the bottom to confirm: *

In an emergency FOOTS UK staff may authorise medical treatment for my child including anaesthetic, if it is not practical to consult me first
FOOTS UK is not liable for any loss, damage or injury sustained during any activities except where such loss, damage or injury can be shown to result directly from the negligence of FOOTS UK
I will inform FOOTS UK of any changes in the details above by contacting the head coach or appointed club admin
FOOTS UK may send me relevant information regarding events and updates
If relevant, my child can travel by any form of public transport, minibus or motor vehicle driven by a FOOTS UK representative or volunteer to any event in which the Organisation is participating
I have read and accept Foots UK Code of Conduct for Young Players
I have read and accept Foots UK Code of Conduct for Adults in Youth Football

Please tick below to confim: *

I have read the declaration above and confirm that the information provided is accurate.

Full Name *

Date *

Signature *

Player Registration and Consent Form

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Player Details

Parent or Guardian Details

Occupation (parent/guardian)

Ethnicity and Religion

Interests

Medical Information

Referral

Consent

FA Respect Code of Conduct

Declaration

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