Washington Juniors Football Club

Established 1990

Washington Juniors Football Club

Membership Application Form

Player's Name *

Date of Birth *

Parent's Name *

Home address *

Post Code *

Home Phone Number

Mobile Phone Number

Email *

Parent's Place of Work

Work Phone Number

Name & Contact number of any other person to be contacted in the event of an emergency

Doctor's Name, Address and Tel. No *

Fears or Habits

Medication

Medical Issues

Any other reason or concern as to why the player should not play for this football team

Team Joining

Juniors
Blacks
Orange

Electronic Signature *

By entering your name here, you are confirming that the information supplied above is accurate and you have read, and agree to abide by, the Club's Code of Conduct

Authentication - enter the text you see below *

Membership fees are £5.00p per week, payable to your team manager, and are payable throughout the term, even in the event of missing training sessions, holidays, and injuries unless agreed by management committee.

There will be a £5.00p Registration fee payable at the beginning of each season

The club will not be held responsible for any incidents involving the player prior to or after Training Sessions and Football Matches.
It is the responsibility of the parent to make sure the player is taken to and collected from Training Sessions and Football matches.
Any problems contact the Team Manager.

Washington Juniors Football Club

Established 1990

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