COTTAGE FARM RANGERS F.C.
cfrfc.org.uk
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A Nationwide F.A. Charter Standard Development Club.

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Official Club Membership Registration Form 2012-3

 

Team and Age Group: ……………………………………………………………………………………………………………..

 

 

Full Name     ………………………………………….         In the Event of any emergency, we give

Home Address   …………………………………….          permission for medical treatment.

                       …………………………………….         

                       …………………………………….         Name     ................................................. 

                       …………………………………….         Relation to Player   ....................................

Post Code        …………………………………….         

Home Tel No     …………………………………….         Signature     ............................................ 

Date of Birth     …………………………………….

E-mail address ……………………………………..          Address     ..............................................

                                                                                   ..............................................

Signed              …………………………………….                         ..............................................

                                                                                   ..............................................

 

Medical Details                                              Home No     ............................................

                                                                   Mobile No     ........................................... 

Please indicate if you have any medical          Email:        ............................................

conditions that we should be made aware

of.                                                                             (Required for Under 16's)

e.g. Asthma etc.,

 

…………………………………………………………………       In signing this form, it is assumed that you agree     

…………………………………………………………………       to the rules and regulationsof the Club, and that

…………………………………………………………………       no liabilities are outstanding in relation to

…………………………………………………………………       prevous Clubs.

…………………………………………………………………      

……………                                                       No player will be allowed to play for this Club

                                                                   until a signed copy of this form is received by

                                                                   the Club Secretary.

 

Club use only;

 

Managers;

 

Please indicate that you have read and

understood the Managers Roles and

Responsibilities document.

 

Managers Name   ……………………………………

 

Signature          ……………………………………