Netherton United Football Club Players Registration and Consent Form
2020/21 Season
Dear Parent / Guardian & Player. Welcome to Junior and Youth Football at Netherton United Football Club. For some, this will be your first experience of our club, and we warmly welcome you.
Please ensure you complete and read all sections, anything added to this form will be held in confidence. The club and our coaches need to know these details in order to meet the specific needs of your child.

Player details
2020/21 Team (please select)*
Players Name*
First Name Last Name
Address*
Street Address
Street Address Line 2
City County
Post Code
Date of Birth*
Month Day Year
Date
Age*
School Attending*
Previous Club Registered
if you were registered with Netherton United last season please leave blank

Parent / Guardian Information
Parent / Guardian Name*
First Name Last Name
Date of Birth*
Month Day Year
Date
Relationship to the child*
father, mother, guardian etc.
Address (if different to the Players)
Street Address
Street Address Line 2
City County
Postal / Zip Code
Email*
example@example.com
Phone Number*
Area Code Phone Number
Alternative phone Number
Area Code Phone Number
FAN Number (if known)
An FA Number (FAN) is a unique identification number which holds all your details on the FA administration system. if you have ever registered on an FA website you will ave been issued a FAN Number.

Medical Information
Name of GP*
GP Phone Number*
Area Code Phone Number
Details of any known conditions, allergies etc (asthma, diabetes, epilepsy, foods):
Any medication being taken:*
Yes No
Any other special need, requirements/ directions that would be helpful for coaches to know about
Additional Emergency Contact Details (if the parent / Guardian cannot be reached)
First Name Last Name
Phone Number
Area Code Phone Number
I will inform the Club /Coaches of any important changes to my child’s health, medication or needs and also of any changes to our address or phone numbers given above. In the event of illness, having parental responsibility for the above named child, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication.*
Yes No

Players Code of Conduct
I have read, understood, and hereby agree to abide by the above players code of conduct. I will also ensure my child will read and abide by the code.*
Yes No

Parents Code of Conduct
I have read, understood, and hereby agree to abide by the above Parents code of conduct.*
Yes No

Club Policy
Payment of Player Fines
Please pay particular attention to this point, so as to save any confusion at a later date. Parents/Guardians will be responsible for payment to the club of any fines or administration costs incurred by their son/daughter whilst playing junior or youth football for Netherton Utd FC. These will normally be through a sending off or caution.

Transport
I acknowledge that any arrangement to transport my child to or from Club games or activities is my responsibility. Determining the insurance or roadworthiness of vehicles or drivers is not the responsibility of Netherton United Football Club Ltd or its officials.

Photography
I agree to photographs/videos of my son/daughter being taken by Netherton United for football purposes.

Car Park
Please respect Disabled parking bays. Please park sensibly in bays as marked. Please respect our patrons and also near neighbour’s, the residents of Charlotte Way, by driving carefully and at a sensible speed when entering and leaving the car park.
Kit & Eqiptment
All Kit and equiptment provided by Netherton United remain the property of Netherton United and must be returned to the football club immediately upon request or as and when a player leaves the Club.
I have read, understood, and hereby agree to abide by the above Club policy.*
Yes No

Sign & Submit
Player Registration is not complete until this form has been Signned and Submitted. A Player Registration Fee of £25 will also need to be collected.
I hearby confirm all information provided in this Player Registration & Consent form to be accurate to the best of my knowledge
Name
First Name Last Name
Signature
Clear
Date
Month Day Year
Date
Should be Empty:

Netherton United Football Club Players Registration and Consent Form