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Wareham Rangers Junior Section and the Dorset FA require all children to be registered with a club to cover the insurance |
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WAREHAM RANGERS J.F.C. REGISTRATION FORM (Season 2010-2011) |
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PLAYERS FIRST NAME …………………….………….……… PLAYERS SURNAME …………………………………….………….. |
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DATE OF BIRTH ……….…. / …….…... / …….……. |
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PARENTS FORENAMES ………………………………………………..……………………………………………………………………. |
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ADDRESS …………………………………………………………..………………………………………………………….……………….. |
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………………………………………………………………………..…………………………….…… POSTCODE ……………………….. |
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TELEPHONE NUMBER HOME ……………….……………………..……………… MOBILE …………...………………………………. |
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EMAIL ADDRESS ……………………………………………………………………………..……………………………………………….. |
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ANY OTHER CONTACT NUMBERS ……………………………………………………..…………………………………………………. |
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CHILDS SCHOOL YEAR FOR 2010-2011 SEASON: YEAR ………..…….…. UNDER …………...……. |
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PARENTS CONSENT SIGNATURE TO ALLOW INDIVIDUAL TO JOIN WAREHAM RANGERS YOUTH FOOTBALL CLUB |
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…………………………………………………………………………………..………………………………………………………………… |
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PARENTS CONSENT TO, AT TIMES WITH PRIOR AGREEMENT, TO TAKE PICTURES AT |
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MATCHES AND PUBLISH ON WEBSITE, BUT WITHOUT NAMES |
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……………………………………………………………………………..……………………………………………………………………… |
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ANY MEDICAL CONDITION THAT THE CLUB SHOULD BE AWARE OF |