Chairman/Secretary: John Penkethman
treasurer: Lynda Penkethman
email:
web:
Exeter & District League - Team Application Form 2015/16 Season
Club Name / County FA Affiliation NO:Club Secretary Name
ClubSecretary Address
Tel / Mobile / E-mail
Club Welfare Officer Name / Tel / E-mail
Please Indicate does your club have Charter Status / YES / NO
Team Name
Age Group
(PLEASE TICK ONE BOX ONLY) / U7 Mixed / U8 Mixed / U9 Mixed / U10 Mixed / U11 Mixed / U12 Mixed
U13 Mixed / U14 Mixed / U15 Mixed / U16 Boys
Contact details of manager/coach
Manager/Coach Name / Current Coaching Level / Do You Have a Current CRB Certificate
Tel / Mobile / E-mail
Home Ground
Name & Address
Postcode
Home Colours
/ Shirt / Away Colours / Shirt
Shorts / Shorts
Socks / Socks
ALL DETAILS MUST BE COMPLETED IN BLOCK CAPITALS - FORMS THAT ARE ILLEGIBLE WILL NOT BE PROCESSEDWITHOUT EXCEPTION – Deadline for application to the League is 21st July 2015
by registering with the Exeter & District Youth league you agree to abide by the League / FA Rules and agree to ensure all players have valid and up to date Devon FA ID cards prior to the start of the 2015/16 season.
Signed by : Print Name: Position with Club:
Registration Fees:All Age groups team registration fees will be £50 per team Please send this form together with the team fee of £50(per team wishing to play in season 2015/16)
To: - John Penkethman, Exeter & District Youth League, 41, Quarry Park Road, Heavitree, Exeter, EX2 5PB.
Please make all cheques payable to –Exeter & District Youth League
NOTE: All teams applying for entry to the Exeter & District Youth LeagueMUST be FA Affiliated.
All teams applying must have a Welfare Officer who has completed ALL the relevant courses.
All teams must have Charter status or be working towards the award.
Please ensure you enclose a SAE envelope with your form and cheque in order that we can notify you if you have been accepted into the league– The Management Committee reserve the right to refuse entry.
INSTRUCTIONS FOR FILLING IN THE FORM
1: FILL THE FORM IN ON YOUR PC/LAPTOP
(DO NOT FILL IN BY HAND UNLESS YOU FILL IN COMPLETELY IN BLOCK CAPITALS)
2: PRINT THE FORM OUT
3: POST THE FORM ALONG WITH THE CHEQUE MADE OUT TO “EXETER & DISTRICT YOUTH LEAGUE” TO
John Penkethman
41, Quarry Park Road
Heavitree
Exeter, EX2 5PB
4: IF YOU REQUIRE A RECIEPT FOR THE PAYMENT PLEASE ENCLOSE A SAE. NO SAE = NO RECIEPT
5: DO NOT LEAVE IT TO LATE.
21ST JULY IS THE DEADLINE WITHOUT EXCEPTION
FORM Reg15/16- EDYL