EmailMe Form - Ossett Town Juniors Player Registration 2017-2018

Player's Name *

First Middle Last

Date of Birth *

DD / MM / YYYY

Age Group (2017/18 season)

Parent/Guardian's Names

Player's Address *

Street Address City State / Province / Region Postal / Zip Code

Email Address *

Main Contact Number *

Alternative Contact Number

Please note any Medical Conditions *

If not applicable, please enter 'None'.
If you are asthmatic then please bring a spare inhaler for your coach to keep in case of emergencies.

Emergency Contact *

First Last

Contact Number *

Alternative Emergency Contact

First Last

Contact Number

Club Registration Fee

A payment of £45 is required as a registration fee.
This is reduced to £20 if starting after 1 Jan 2018.

Please select payment method

Cash in full to age group manager

Cheque (made payable to "Ossett Town Juniors")

Bank Transfer

Contact your age group manager for bank details.

I agree to be bound by, and to observe, the Club’s Rules and Constitution and the Rules and Regulations of The Football Association and relevant Leagues, and all competitions in which the club participates.
I confirm that the above information can be used by officials of Ossett Town Juniors in the running of the junior football club.

In the event that my child is injured while playing football or travelling to and from football events and I cannot be contacted, I hereby give consent for my child to receive medical attention.
I also give consent to photographs being taken of my child participating in football activities (photographers to be approved by the age group manager) for use on the club's websites and for press and PR purposes.

*

I accept