Full Name / Date of Birth / School Year
@ 01/09/2017
Home Address Inc. Post Code
Emergency Contact Details

In the event of an emergency, please give two contact names and numbers

Parent/Guardian contact details / Home / Mobile Number / Email
1.
Parent/Guardian contact details / Home/ Mobile Number / Email
2.
Medical Details

Please indicate if your child has any medical conditions we should be aware of e.g. Asthma

Parental Consent

In the event that my son/daughter is injured whilst playing football/travelling to and from football events

and I cannot be contacted on the above number, I hereby by give consent for my child to received medical attention

Signed / Print Name
1.
2.

I enclose £25 annual family membership fee, and agree to pay the subscription

fee of £110.00

Ethnic Origin: (please tick)

British WhiteChineseBlack Caribbean Black African Indian

Pakistani Other: (please specify)

From time to time members of Wye Juniors FC may be photographed whilst taking part in activities. If you do NOT wish your child to be included in nay publicity materials please tick here.
All information will be handled in a secure and confidential manner and held in accordance with the 1992 Data Protection Act. If you do NOT wish your address to be retained n our data base, please tick here.

Page 1 of 3 to be returned

With the development of grassroots football, The FA, along with County FA’s and local Leagues have piloted an online Player Registration Platform, which has been very successful.

They have now decided to make this system ‘Live’ from the start of this season (2017/18).

East Kent and Weald of Kent Leagues are putting this into action straight away, but Ashford & District are allowing us to use the old paper method and online process together for 2017/18 season.

Moving to online registration, initially will be a lot of hard work for the Club, but, it will benefit us in the long term.

Unfortunately, this new online system requires each player to be entered individually, to gain an FA Fan number, which will be unique to them for their entire football career, boy to adulthood. As our players are under 18 years old, consent will be required from their parent/carer, this will again be in the form of parent/carer obtaining a FA Fan number (if they don’t already have one). To register for an FA Fan number please click on the link below and follow the instructions. Please remember to make a written note of the number.

If you already have a FA Fan number or you are unsure of the number please give us your name and DOB or number.

Once the player details have been entered, I believe that you will receive an email with a link and be asked to enter your consent, this is where you will require your Fan number.

I/we give my/our consent to Wye Juniors FC to use the player registration in respect of my/our son/daughter, and to obtain a FA Fan number.

Signed:Printed: Dated:

Along with Club Membership Form, signed Code of Conduct we will require: 4 pages in total.

ADYFL – Teams U8, U9, U10, U11, U13, U14’s – 2 passport size photos. League Registration Form.

In respect of the Under 8’s we will require all the above, plus a copy of Birth Cert or Passport (to confirm DOB)

EKYFL & WKFL we will require, Club Membership, signed Code of Conduct, 1 passport size photo. All new players will require copy birth cert or passport as well.

This is a new system to us all, so there may be some hiccups along the way. Please bear with us.

Page 3 of 3