Timperley & District Junior Football League Player Registration Form

Timperley & District Junior Football League Player Registration Form - 2017/18

Timperley & District Junior Football League

Player Registration Form 2017/18 – SCPR1

(PLEASE COMPLETE IN BLOCK CAPITALS AND INK)

I, the undersigned, wish to be register to play U..........

for.............................................................................JFC

Registration Date: ........................................................

Full Name:

......................................................................................

Home Address:

......................................................................................

Post Code: ..................................................................

Tel No: ……………………………………………………………………..

Emergency Tel No: ……………………………………………………

Date of Birth: ...............................................................

School: …………..............................................................

Does the Player have any allergies: (provide details)

.......................................................................................

.....................................................................................

Enclose further details with this form if required

Does the Player have any impairment/disability:

......................................................................................

………………………………………………………………………………….

e.g. Hearing, Visual, Cerebral Palsy, Learning, Amputee - this

information is being requested by The FA to help identify players

for the Disability Talent Pathway.

Player Signature: ……………………………………………………….

Parents Signature: …………………………………………………….

Club Secretary Signature: ………………………………………….

Registration Secretary Signature: ………………………………

SCNP SCPR1 200517

Timperley & District Junior Football League Player Registration Form - 2017/18