TEMPLATE: Junior Membership

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Firstly, please tell us a little bit about the applicant...
Applicant's Name Applicant's Name First Last
Applicant's Date of Birth Applicant's Date of Birth / DD / MM YYYY
Applicant's School
Applicant's School Year
Gender
Ethnic Origin
Next, please tell us how to get in touch with the applicant and their parent/ carer...
Parent/ Carer Name Parent/ Carer Name First Last
Home Telephone Number
Personal Mobile

Please provide the applicant's mobile number if they have one
Parent/ Carer Mobile
Parent/ Carer Email
We may need to contact you or another responsible adult in an emergency; we may also need to seek medical assistance, so please CAREFULLY complete the details below...
Emergency Contact Name Emergency Contact Name First Last
Emergency Contact Phone
Doctor's Name

Please provide the name of the applicant's usual doctor
Surgery Name

Please provide the name of the applicant's usual doctor's surgery
Surgery Phone
Medical Conditions
If none, please enter N/A
The next few questions apply to the parent/ carer of the applicant...
PARENT: Occupation
PARENT: Photography

As parent/carer, I have no objection to the applicant being photographed when playing, as authorised by the coach.
PARENT: Committee

I am interested on serving on the committee
PARENT: I can help by...

Our club is run almost entirely by volunteers. There are a large number of them, but more can help to expand and improve the club.
Almost finished, just the formalities to complete...
I have read the club's terms and conditions

I have read the club's terms and conditions Confirm
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

TEMPLATE: Junior Membership

TEMPLATE: Junior Membership

Firstly, please tell us a little bit about the applicant...

Next, please tell us how to get in touch with the applicant and their parent/ carer...

We may need to contact you or another responsible adult in an emergency; we may also need to seek medical assistance, so please CAREFULLY complete the details below...

The next few questions apply to the parent/ carer of the applicant...

Almost finished, just the formalities to complete...