2021/22 Season Membership Form Player Name Player Date of Birth DD/MM/YYYY Primary/ Secondary School Image of Player - The FA database (WGS) require an image of your child which they will be uploaded onto their database. The image should show head and shoulders only, be of a quality that will clearly identify your child, and have been taken recently (within the last 6 months). Smiling is okay, but ensure that no hats or clothing cover facial features. Your application will be rejected if this is not completed. Saturday Football Team Name and Age Group NO TEAM SELECTEDU7 LionsU7 PumasU7 TigersU7 WildcatsU7 Lionesses GirlsU7 Wildcats GirlsU8 Lions - ColinU8 Pumas - MattyU8 Tigers - Jason & AaronU8 Wildcats - Paul & RichieU8 Tigons - NeilU8 Lionesses Girls - OliviaU9 Lions - AndrewU9 Pumas - Craig & AdamU9 Tigers - Christian & JohnU9 Wildcats - EmmaU9 Lionesses Girls - Paul & ShaunaghnessyU9 Wildcats Girls - PaulU10 Lions - Darren & PhilU10 Pumas - ChrisU10 Tigers - Colin & MarkU10 Wildcats - AndyU10 Tigons - Andy & DannyU10 Wildcats Girls - Wayne & AbigailU10 Lionesses Girls - Mark & ColinU10 Tigers Girls - RichardU11 Lions - David & JeffU11 Pumas - Marty & MartinU11 Tigers - David & DaveU11 Wildcats - Peter & AnthU11 Tigons - Simon & DavidU11 Jaguars - Arrif CassinU11 Lionesses Girls - Gary & SimonU11 Wildcats Girls - Lee & ChrisU12 Lions - Chris & JaysonU12 Lynx - Paul, Craig & JackU12 Tigers - Anth & DamionU12 Pumas - Darren & AndyU12 Wildcats Girls - Graeme & LauraU12 Lionesses Girls - Neil & GrantU12 Jaguars - Danny & LeeU12 Tigers Girls - MarkU13 Tigons - Jamie & PaulU13 Tigers - Stu & RichieU13 Lions - Ash & ChrisU13 Wildcats - Gav & IanU14 Tigons (NFL) - JamieU14 Pumas - Steve & NeilU14 Wildcats - David, Michael & MichaelU14 Tigers - Jack, Helen & TrevU14 Lions - MichaelU14 Panthers - Alan & NickU14 Lionesses Girls - Mick & OliviaU14 Wildcats Girls - Dave & CraigU15 Tigers - Andy & DomU15 Wildcats - Chris & StevenU15 Lionesses - AdamU16 Tigers - Rob, Keith & RobU16 Girls - Simon & LeeU17 Tigers - Alan & DominicU18 Wildcats - TomU18 Girls -U21 (DCFA) Sunday Football Team Name and Age Group NO TEAM SELECTEDU9 Jaguars (DCFA) - Andy & AdamU9 Tigons (DCFA) - JohnU10 Lions (DCFA) - DarrenU11 Panthers (NFL) - Danny & LeeU12 Tigons (NFL) - Malcolm & StevynU14 Tigons (NFL) - JamieU14 Lions (DCFA) - MichaelU15 Lionesses (DCFA) - Adam Home Address – number and street name Town or City Postcode Primary Carers Name for Players U18 Primary Occupation Primary Carers Date of Birth DD/MM/YYYY Primary Carers or Players Mobile Telephone Number Primary Carers or Players Email Address – this is required to register the player on the FA Database. This email will also be used for any club communication. Secondary Carers Name Secondary Occupation Secondary Carers Mobile Telephone Number Secondary Carers Email Address Does the player have any known health needs? The Club are always looking for volunteers to assist with various roles within the Club e.g. Coaching/ Admin/ Grass Maintenance. Would you be interested in supporting your Club? YesNo If Yes, which role are you interested in? NilCoachAdminGrass MaintenanceOther Do you consent to images of your child if U18 or yourself if over 18 appearing on our social media sites? 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. YesNo Club Welfare - FA regulations and guidelines dictate that as a charter standard Club, we must have a Club Welfare Officer in place, along with a Safeguarding Policy, and relevant codes of conduct. All of this information can be found online here - please take the time to visit the page, ensure you are aware about who our CWO's are, and how you can deal with any welfare issues. YesNo By selecting 'Yes' from the drop down box below, as the child's primary carer you are agreeing to the safeguarding policies we have in place, and that you are aware of who the Club Welfare Officer is. YesNo Club Code of Conduct for Players and Parents - Please read our club code of conduct for the season, which can be found online here By selecting 'Yes' from the drop-down box below, you are agreeing to abide by our Clubs Code of Conduct for Players and Parents. YesNo Subscription Payments - The Club requires monthly subscription payments from all of it's participating members, and has an instruction in place which must be adhered to by all. By selecting 'Yes' from the drop-down box below, as the child's primary carer or player if over 18 you are agreeing to the policy we have in place, and pledging to initiate and maintain your monthly subscription in a timely manner. YesNo Pro Direct size guide can be found online here PLEASE ORDER KIT VIA YOUR COACH