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Registration Form U7 & U8

WELCOME TO Blackmore Youth FC

Registration Form U7 & U8

ANNUAL MEMBERSHIP AND CONSENT FORM 2024/2025 SEASON

It is important you fill in the rest of this form as fully as possible. Failure to disclose items could mean the safety and welfare of your child is compromised. The club cannot be held responsible if information has not been shared.

Player Full Name: *
Please enter players full name.
FAN Number:
Enter the player's FAN number if available.
Date of Birth: *
Enter the date of birth of the player.
Home Address: *
Enter the player's home address.
Post Code: *
Enter the postcode of the player's home address.
Phone Number: *
Enter the player's phone number.
Age at start of season: *
Enter the player's age at the start of the season.
E-Mail: *
Enter your email address.
Place of Birth: *
Enter the player's place of birth.
School / College: *
Enter the name of the player's school or college.
Parent/Legal Carer Full Name: *
Enter the full name of the player's parent or legal carer.
Parent/Legal Carer Phone Number: *
Enter the phone number of the player's parent or legal carer.
Parent/Legal Carer E-Mail: *
Enter the email address of the player's parent or legal carer.
Does your child have any known medical conditions or health needs? (e.g. Diabetes, Asthma, Epilepsy, Allergies) *
Select whether the player has any known medical conditions or health needs.

Please provide details:
Current Medication Name:
Enter the name of the medication the player is currently taking.
Dose/Frequency:
Enter the dose and frequency of the medication.
What does the club need to do to help keep your child well?
Describe what the club needs to do to help keep your child well.
Do club members need any additional medical training other than first aid to care for your child? *
Select whether club members need additional medical training.
Does your child have any access needs? *
Select whether the player has any access needs.
Does your child have any communication needs? e.g. non-English speaker/hearing impairment/sign language user/dyslexia? *
Select whether the player has any communication needs.

please tell us what we need to do to enable him/her to communicate with us?
Describe what the club needs to do to help the player communicate.

At times, the club may wish to take photos or videos of the team or individuals within 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 the promotion and celebration of the activities of the club and for training and educational purposes. Please indicate if this is acceptable to you?

Please indicate if taking photos or videos is acceptable to you? *
Select whether it is acceptable to take photos or videos of the player.

If you have any additional information which you wish to share with the club, please contact the club designated person.

Travel

Arrangements will be made to collect and return children to specific pick-up points. The Club’s responsibility stops and starts at these points. It is your responsibility to arrange safe travel to and from the pick-up points. If you are ever delayed in collecting your child, please make every effort to contact the Club Contact or the escorting helpers so we can discuss arrangements for your child.

Non-Football Activities

There may be occasions when your child is involved in planned and structured non-football activities such as a trip to the cinema, bowling or participating in a fund raising event. The Club will have collected appropriate information in preparation for the activity (e.g. about the journey, the children’s various needs and helper skills), identified any potential risks or dangers, minimised the risks and dangers by careful planning and precautions and made sure we know who is responsible for putting precautions into place (e.g. who will carry the First Aid kit). This process is called a risk assessment.

Emergency Contact Name: *
Enter the name of the emergency contact.
Emergency Contact Phone Number: *
Enter the phone number of the emergency contact.
Emergency Contact Email Address: *
Enter the email address of the emergency contact.

Registration Fee

An annual registration fee is required no later than 30th September 2024 for forthcoming season. The annual amount due is £200 and can be made by cash, cheque made payable to Blackmore Youth FC or Bank Transfer to:
Blackmore Youth FC
Sort Code: 60-03-25
Account No: 77324889

Registration Fee: *
Enter the amount of the registration fee.
Select Team
Please select the team the player is registering for.
Consent of Parent/Legal Carer
I give consent for my son/daughter to participate in Blackmore Youth Football Club’s events and agree to the conditions outlined above. I accept that it is my responsibility to inform the Club directly of any changes to the details recorded on this form.
Name of Parent/Legal Carer: *
Enter the consent details of the parent or legal carer.