Application Form

Child name

Date of birth

Gender

Team age group as of season 2022/2023 Team age group as of season 2022/2023Under 8Under 9Under 10Under 11Under 12Under 13Under 14Under 15Under 16

Address

Town

County

Post Code

Does your child have any allergies?

Does your child have any medical conditions?

Is your child taking any medication?

School

School year as of September 2021

Emergency contact 1 name

Emergency contact 1 phone

Emergency contact 1 mobile

Emergency contact 1 email

Emergency contact 2 name

Emergency contact 2 phone

Emergency contact 2 mobile

Emergency contact 2 email

Permission for photos/videos to be taken and published to social media and the website Permission for photos/videos to be taken and published to social media and the websiteYesNo

birth certificate