Youth Registration Form 2018

South East United Football Club Inc.

Player Surname: Player First Name:

Date of Birth: Age as at 1 Jan 2018:

Sex: M or F (Please Circle) FFA Registration No. (if known):

Mailing Address:Post Code:

Home Phone: Mobile:

Email:

School attended (if applicable): Grade:

Medical information: (Note any illness or condition which may adversely affect the player)

Please indicate if you or family members can assist with any of the following (all help much appreciated!):

Coaching: ◻ Team Manager/Assistant: ◻ Committee: ◻ 1st Aid Help: ◻ Canteen: ◻

Full registration fee $220 (or $200 if paid in full before March 31st 2018)

Full payment (or alternative arrangements) must be made prior to participating in any official match

No alcohol, smoking or dogs are allowed on School or Council grounds. Participants are respectfully requested to remember that the game is for the enjoyment of the players. By adopting a co-operative attitude towards officials and setting a good example with regard to conduct and language, participants and supporters can assist us to achieve our aim and all will enjoy their game. It is expected that all players are involved in supporting the club by assisting with fundraising, canteen, ground setup and other activities to ensure the success of and promote the club. You may be called on from time to time to assist with these activities and your co-operation is greatly appreciated.

I accept that I (or my child(ren)) will play football knowing that personal injury may occur during football or football training. I accept that we are bound by the rules of the game as administered by Football Federation Tasmania. In consideration of Football Federation Tasmania and SEUFC permitting participation in organised football, I release and discharge Football Federation Tasmania and its servants or agents and SEUFC and its servants or agents from all liability for injury, loss or damage to me or my family as a result of playing or training in football.

I authorise SEUFC, Football Federation Tasmania and their sponsors to use photographs, images and recordings of myself or family members for publications and public relations activities of SEUFC, FFT and authorised sponsors.

I agree I have read and understood this warning, release and indemnity.

Player Signature:

(Parent/Guardian to sign if player under 18)

Print Name: Date: ….…/……./…..…

Contact Ph. No. (if different to player):