Membership & Medical Consent Form

Cholsey Bluebirds FC

Membership & Medical Consent Form

Enrolment Fee - £65 (£35 for second or more children)

Cheques made payable to Cholsey Bluebirds FC

Please complete in BLOCK CAPITALS

Player’s FULL Name: ......

Date of Birth ......

Address......

...... Postcode ......

Contact details (including extra Emergency contact) – please print clearly

Medical details

Please give details of any medical conditions of which the club and coaches should be aware of : eg. Asthma and allergies to any medications.

Disability

The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘physical or mental impairment, which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities’. If you consider yourself to have a disability, please let us know the nature of the disability and any relevant details.

Photography

Pictures of teams, squads, players and Managers/Coaches with players may be taken to use on the Cholsey Bluebirds website or in club publicity material. By signing this form, you are deemed to have given your consent to pictures that include your child, to be taken and used in the aforementioned ways in accordance with Child Protection guidelines, unless you have ticked one or both of the following boxes.

I/we do not wish photos which include my/our child(ren) to be used.

I/we wish to be consulted before photos which include my/our child(ren) can be used.

The above information will be used solely by Cholsey bluebirds Football Club for the purpose of Membership and club matters. The information will not be passed on to any third party and will be held in accordance with the Data protection Act.

I, the parent/guardian, consent to the named player being registered with Cholsey Bluebirds FC as a player. We (the player and I) will abide by the Constitution, rules and codes of Conducts as laid down by Cholsey Bluebirds FC and understand that failure to do so could result in registration being withdrawn. Copies of these documents are available on the Club website :

Signed ...... Date ......

Please read the statements & information points on page 2 carefully, before signing. Please retain page 2 for your reference.

PLEASE RETAIN THIS PAGE FOR YOUR REFERENCE

Glasses

Please note that children cannot wear normal glasses when playing or training. They need to wear sports goggles which can be prepared with prescription lenses, but which will prevent any injuring during play or training. Opticians such as Specsavers sell sports goggles and you should contact them directly for information.

Jewellery

Please remind your child that all jewellery, metal/plastic hair band and grips, wrist bands and watches must be removed before taking part in training or matches. Note that taping over ear studs etc, is not acceptable. This a mandatory FA rule and by ensuring that your child knows beforehand it will save everyone any possible embarrassment at training or on match days.

Injury

Parents are advised to ensure that they take out adequate insurance cover for any potential loss or earning from looking after a child should they suffer and injury (e.g. broken limb) whilst taking part in any football activity in connection with the club. All due care and attention will be taken by members of the club whilst all children are in their care and an accident book will be used to log any injuries, accidents or incident that requires treatment of any kind, and parents will be asked to sign the relevant log.

CODES of CONDUCT

Players should ………

• Remember that the real goals of the game are to enjoy it and to improve their football skills;
• Play to win within the boundaries of fair play and the laws of the game;
• Work hard for their team as well as for themselves;
• Show respect towards match officials at all times;
• Accept the decision of the match official without protest;
• Always control their temper and never use foul or abusive language;
• Show respect towards the opposition and their supporters;
• Be on time and prepared for all training sessions and matches;
• Always support and encourage their team-mates;
• Show respect to their coach/manager.

Parents and supporters should …….

• Remember that children are playing football for their own enjoyment & benefit, not for the spectators;
• Not coach from the touchline during matches or training;
• Not argue with or shout at the referee or other officials;
• Support and encourage all the players in the team, never ridiculing mistakes;
• Applaud the opposition as well as your own team;
• Help your child and others to focus on the performance and not the result;
• Discuss any concerns with the coach and not criticise him/her to your child or to other parents –

show respect at all times to coaches who are giving up their own time for the children.

What can You do for Cholsey Bluebirds ?

During the season our tuck shop raises vital funds to pay for referees and energy costs for our pavilion. On match days it is run entirely by the parents of the teams on a rota basis. Your ongoing support will be very much appreciated.

Any help setting up goals/respect barrier before and clearing them away after a match is very much appreciated.

Also, at our end of season Summer Tournament, our main fund-raising event, we rely entirely on parents and volunteers to help with preparation during the week before, man the refreshment tent and BBQ over the weekend and help with clearing up on the Sunday afternoon.

Is there anything else you can do to help Cholsey Bluebirds?

• Maybe you would consider helping to run a team;
• Maybe you can help maintain the pavilion by providing resources and skills;
• Maybe your company can provide sponsorship for kit or sponsor an event.

Please look at our website for more ideas at

For your reference :

Team Manager …………………………………………………………………….

Rising Stars / U7s / U8s / U9s / U10a / U11s / U12s / U13s / U14s / U15s

Contact details : Tel no ……………………………………… Mobile no …………………………………………

E-mail address : ______

Address : ______

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