Register Player

Player First Name

Player Surname

Enter Player d.o.b

Player Age (yrs) at start of coming season

Select Age Group/Team
U6U7U8 SharksU9 FalconsU9 RaidersU10 CobrasU10 CometsU10 TitansU11 TigersU12 VipersU13 SpartansU13 TrojansU14 KnightsU14 WarriorsU15 HurricanesU15 Red KitesU16 WolvesU17 Greens

Player Status for above team
Training OnlyTraining plus League registeredTraining, League Registered & Futsal

Does player play for another Winlaton team?
NoU6U7U8 SharksU9 FalconsU9 RaidersU10 CobrasU10 CometsU10 TitansU11 TigersU12 VipersU13 SpartansU13 TrojansU14 KnightsU14 WarriorsU15 HurricanesU15 Red KitesU16 WolvesU17 Greens

Player Status for above team
Not ApplicableTraining OnlyTraining plus League registeredTraining, League Registered & Futsal

Player Home Address
Line 1

Line 2

Line 3

Postcode

Parent/Carer Full Name

Parent/Carer Contact Number

Second Parent/Carer/Emergency Contact Full Name

Second Parent/Carer/Emergency Contact Number

If Child is not living with parents, please clarify the legal status of the child and his/her current carers

Does your child have any known health/medical needs? e.g Diabetes, Asthma, Epilepsy, Allergies

YesNo

If you answered yes to the previous question please state below health needs and state specific requirement of club/coach to keep your child well (administer medication, give snacks, call ambulance/seek medical help) please be specific.

In the event my son/daughter is injured whilst playing football and i cannot be contacted on the emergency contact details provided above, my child can receive medical attention:

YesNo

Does your child have any communication needs? e.g non-English speaker/hearing impairment/sign language user/dyslexia etc? If Yes, please tell us what we need to do to enable him/her to communicate effectively with us:

Does your child participate in religion or spiritual practise? Please tell us what it is and what we need to know to ensure your childs preferences/needs are met, e.g are there any dietary guidelines/dress codes we need to follow or support?

At times the Club may wish to take photos or videos of the team or individuals in it. We adhere to The FA Guidelines to ensure these are safe and respectful and used solely for the purposes for which they are intended, which is promotion and celebration of the activities of the Club and for training purposes. Please indicate if this is acceptable to you.
If you have any additional information which you wish to share with the Club, please contact the club Designated Person.

Yes - I'm happy for photos and videos to be taken of my childNo - I do not wish for photos or videos to be taken of my child

There may be occasions when your child is involved in planned and structured non-football activities such as a trip to the cinema, bowling or participating in a fundraising event. The Club will have collected appropriate information in preparation for the activity (e.g. about the journey, the children’s various needs and helper skills), identified any potential risks or dangers, minimised the risks and dangers by careful planning and precautions and made sure we know who is responsible for putting precautions into place (e.g. who will carry the First Aid kit). This process is called a risk assessment.
There may be occasions when your child is involved in planned and structured unsupervised non-football activities (e.g. shopping trips) whilst on tour. Players will only be permitted to participate in these activities if it is considered appropriate to do so. You will be informed prior to the event if any form of remote supervision will take place for such activities and the nature of these activities

I understand information aboveI do not wish for my child to be involved in any events outside of football

There may be occasions when your child has the chance to be involved in planned and structured swimming activities. On these occasions appropriate supervision, including qualified lifeguard cover, will be provided.

I confirm that my son/daughter can swim 50 metresI confirm that my son/daughter is confident in a poolI confirm that my son/daughter is confident in the sea or in open inland waterI do not wish for my son/daughter to take part in any swimming activities

Please upload passport style photo of the player to be registered

Parent/Carer - To the best of my knowledge all information above is correct and I agree to the player named above playing for Winlaton Community Juniors FC. (Please enter name below. By doing so this acts as your signature on this document)

Ensure today's date is selected