Player Registration Form 2019/20 Season

Player Details

Full Name

Home Address

Postcode

Date of Birth (dd/mm/YYYY) - type in DOB as dd/mm/YYYY format or use the Date Picker

School Name

School Year as at 1st September

Name of Registered Doctor/Surgery

Does your child/dependant have any medical conditions or takes regular medication? No Yes

Medical Details

Parent/Guardian/Social Club Membership Details

Note: Included in your registration fee is the social club membership - 2 adults per child. Every player being signed on will be issued a family membership under the signing on details of the parent.

Full Name

Email Address

Relationship to Player

Emergency Contact Number

Second Emergency Contact Name

Second Emergency Contact Number

Is there a second emergency contact? No Yes

Registration Fee

The fees payable per player are assessed to cover the Club's cost for League Fees, Training Costs, Pitch Hire Charges, CRB Checks, Insurance and Equipment. They also include an amount for club membership which is necessary to permit use of the bar and clubhouse facilities under its licence conditions.

Select Player's Age Group / Fee

Do you have a sibling ALREADY REGISTERED with the club for the current season? No Yes

Team

Fee

Discount

Total

Sibling Discount

If you have more than one sibling registered with the club you are entitled to a £15 discount**

This is redeemed by emailing treasurer@felixstowefootball.co.uk providing your name, children details registered with the club plus your bank account you wish the money to be transferred to (Name of bank, Sort Code and Account Number).

** Note: Only one £15 discount per family and will be redeemed after your full payment has been processed.

Are you entitled to child discount? No Yes

Agree to Terms

Please read the Club Ethos and Terms & Conditions before proceeding:

Club Ethos

F&WUCSLtd Member Rules

Terms & Conditions

All information is available at: http://felixstowefootball.co.uk/juniors/information-registration

I/We have read the terms and conditions, and agree/consent to the abide by the Club rules, Code of Conduct and Ethos at all times.

Payment

Please note: Selecting PayPal also allows you to submit a one-off guest payment using credit/debit card - no Paypal account is needed for this option.

Method of Payment PayPal Bank Payment Cheque

Security

Online payment via PayPal

Thank you for submitting your Player Registration form.

If you made a payment via PayPal, your transaction has been completed and a receipt has been emailed to you.

If you have selected to pay by Bank Payment or Cheque then your registration will not be confirmed until payment has been received.

Please make an online/electronic/direct bank payment to the following account:

Bank Name: Natwest
Bank Account: 39609154
Sortcode: 60-08-17

* Please use the player's name as the payment reference.

Cheques should be made out to Felixstowe & Walton Utd Football Club

Cheques should be sent to:

The Treasurer

Felixstowe & Walton Utd FC

14 Bailey Avenue

Grange Farm

Kesgrave

Ipswich

IP5 2EE

Alternatively please hand cheques in to the Clubhouse or to the respective Team Manager.

To register a new child please start registration at: http://felixstowefootball.co.uk/junior-registration-2019-20

Felixstowe & Walton United FC