For Manager use only:
Registration Form
[ ] League Form enclosed
[ ] 2 Passport sized photos
[ ] Proof of age (if applicable)
2010-2011
[ ] Standing Order
[ ] Full subs
Culcheth Athletic
Football Club
[ ] Reduced subs (sibling)
[ ] TRAINING ONLY
This form entitles the player to train with the Club and become a member of Culcheth Athletic FC. This does not
automatically entitle the player to be invited to play in a League match squad. However, all members of the Club
are entitled to the same benefits whether or not they are invited to play in a League squad.
Mini Soccer League players (U7’s to U10’s) squads operate under the Club’s equality policy and players will be
invited to register for League match squads on the provision that they have demonstrated their commitment to
turn up for weekly training and weekend matches. Mini Soccer players will not be judged on their ability unless
the squad is at near capacity. All League-registered Mini Soccer players will be guaranteed a minimum
playing time, unless a local written agreement has been made between parents and managers.
11-a-side players may be invited to register for League match squads, based on their ability to play football and
on the provision that they have demonstrated their commitment to turn up for weekly training and weekend
matches.
All League Players must complete a Club Registration Form and the appropriate League Registration form.
PLAYERS DETAILS
Player’s Name
Player’s Address:
Home Telephone No.
Parents’ Mobile No
For safety purposes Team Managers must be informed immediately of any change to these
telephone numbers or address
Parents’ email
Player’s Date of Birth
Club Age Group
Team Name (if appropriate)
School Year from Sept 2010
School
CAFC 2010/11 Player Registration Form
Page 1 of 6
PLAYERS MEDICAL HISTORY (Confidential when complete)
Please state any medical conditions (including allergies) that the Club and Coaches need to be aware of
(medical conditions must be disclosed and will not affect your child’s registration)
Please state any behavioural problems i.e. ADHD, ADD, etc (this will not affect your Childs registration but
will assist the Coaches)
PREVIOUS JUNIOR/YOUTH FOOTBALL CLUBS
Parents/guardians must state if their child has been registered with any previous Junior or Youth Football Club
(other than Culcheth Athletic FC) over the past 12 months
Name of Previous Club
Date de-registered from Previous Club
Players who are League registered to any other Junior or Youth Football Club within the playing season will be
required to complete the League transfer process if they wish to join our Football Club.
Players cannot join Culcheth Athletic FC if they owe fees or kit to any other Junior or Youth Football Club. I
declare that I have handed back any items of football kit and equipment which may have been lent to me
by my previous Junior/Youth Football Club and that all training fees were paid to date.
CAFC 2010/11 Player Registration Form
Page 2 of 6
CLUB KIT
Culcheth Athletic FC provides full football playing kit for all League Registered Players, either direct from
Club funds or team sponsorship. Individual teams may provide other items such as tracksuits, raincoats, etc.,
via sponsorship. There is no charge for these items unless they are lost or damaged. If you lose or damage
any item of kit you must inform your Team Manager immediately. A replacement item will be ordered and you
will be expected to pay for the replacement.
Please read the following conditions of use and sign to accept the Club rule concerning kit
loaned to players.
1.
2.
3.
The Club football playing kit (and any other items of clothing) will remain the property of the Club.
I understand that the Club football kit (and any other items of clothing) is on loan to my child.
The Club football playing kit must not be worn during training sessions or any personal use (i.e. playing
out at home) as they may become damaged. The football playing kit must be worn to all official Club
matches.
4. As the parent/guardian signing this letter I undertake full responsibility for the laundering of the Club
football playing kit and any other items loaned to my child.
5. The Club football playing kit (and any other items) must be carefully looked after. I understand that if
any of the items becomes damaged due to misappropriate use then I may be billed for the cost of a
replacement.
6. Similarly if the Club football kit is lost due to carelessness then I may also be billed for a replacement .
7. The Club/Team reserves the right to recall the Club football playing kits at any time.
8. If my child fails to turn up for training on 3 consecutive occasions without informing the Team Manager,
it will be construed that the player has left the Club and the Club football playing kit (and any other
items of clothing) must be returned. I understand that I may be billed for a replacement if any of the
items are not returned.
9. If my child decides that they wish to leave the Club then the Club football playing kit (and any other
items of clothing) must be returned immediately, otherwise I may be billed for a replacement.
10. The Club will not de-register any player to enable them to join another Junior or Youth Football Club,
until all items of Club kit are returned.
Please note that League squad players must wear full and correct Club match kit (Club match shirt,
shorts and socks) for all matches representing Culcheth Athletic FC. Players wearing any item of
incorrect match kit may be excluded from the match.
CAFC 2010/11 Player Registration Form
Page 3 of 6
PARENTAL CONSENT FOR UNACCOMPANIED TRAVEL TO AND
FROM CLUB ACTIVITIES
The Club accepts that older players may wish to travel to and from Club activities un-accompanied
by their parent or guardian.
The Club does not encourage younger players to travel un-accompanied and only recommends players
from Under 13’s age groups upwards to travel un-accompanied to and from Club activities if parental
permission is given.
Please note that the Club cannot take liability for any player from Under 6’s through to Under 18’s
before a training session officially starts or after a training session has officially finished.
I give my permission for my child to travel to and from Club activities un-accompanied for the
2010/2011 Season.
By signing this form on page 5 I understand that Team Managers and coaches are no longer
responsible for my child once an activity has finished.
I understand that ultimately I am still responsible for my child and I should be contactable in
case of an emergency during training sessions and match days.
CAFC 2010/11 Player Registration Form
Page 4 of 6
SUBSCRIPTION FEES
The Subscription for the 2010/2011 Season is £19/month payable for 9 months (01 Sept 2010 – 01 May 2011
inclusive) by standing order. A reduction is offered for those wishing to pay the full subscriptions for the
season when they submit their registration forms. If you wish to take advantage of this, the subscriptions due
for the season are £160.
A reduced rate is applicable for those families registering siblings of players already paying the full amount or
for players who will not be registered with a football league and are considered to be ‘training only’. The
reduced sibling subscription is £9.50/month payable for 9 months (01 Sept 2010 – 01 May 2011 inclusive) by
standing order or £80 if paid in full when registration forms are submitted.
Cheques should be payable to ‘Culcheth Athletic FC’ with the players name/age group on the back.
Subscription fees are payable whether or not a player attends a training session in order to meet Club overheads.
A player’s membership may be suspended if subscriptions fall into arrears.
Registration cannot be accepted unless it is accompanied by the correct subscription fee or a
correctly completed standing order.
Please state the names and age groups of any
siblings registered with the Club
DECLARATION
I agree for my son/daughter to be a junior/youth member of Culcheth Athletic FC to train and play for
their relevant age group. As a parent spectator and associate member of the Club, I agree to abide by the
Club and League rules concerning spectators and to uphold the reputation of Culcheth Athletic FC
Players’ membership with our Club may be affected by the actions of their parents/guardians i.e. abusive
behavior towards match officials etc, or any actions that may cause harm to our Club may result in the
suspension or withdrawal of a player’s membership.
If a player wishes to leave the Club at any time their Team Manager must be informed immediately. By
signing this form I understand that a player will not be de-registered from Culcheth Athletic FC unless all
kit/clothing have been returned and all subscription fees are paid to date. League registered players may
leave and join another junior football club only if they complete the League transfer process. In
accordance with Club and League Rules a player may not register for another Junior or Youth Football Club
until they have discharged all their financial liabilities with their previous Club.
By signing below I am hereby agreeing to the Conditions contained in Pages 1 to 5 of this
Registration Form.
Signed
Print Name
(Parent/Guardian)
Date
CAFC 2010/11 Player Registration Form
Page 5 of 6
Appendix 1
CONSENT FOR MEDICAL TREATMENT IN CASE OF EMERGENCY
Culcheth Athletic FC reserves the right to seek emergency medical attention for any player who sustains an
injury at a training session or in a match if a parent or guardian is not present.
This form must be completed by all parents of players from Under 6’s through to Under 18’s so that emergency
medical treatment of the player is not delayed in case of any medical emergency.
Player’s Name
Player’s Date of Birth
Player’s Address
Home Telephone No.
Parents’ Mobile No
PLAYERS MEDICAL HISTORY
Please state any medical conditions (including allergies) that the Medical Professionals need to be aware
of:
I consent to the above player being treated by a medical professional in case of any medical
emergency in my absence.
I confirm that I am the parent/legal guardian of the above named player.
This Appendix 1 Form will be retained by the Team Manager and must be
taken to every match and training session.
Signed
Print Name
(Parent/Guardian)
Date
CAFC 2010/11 Player Registration Form
Page 6 of 6