East-End F.C – Disability Football EOI Form – East-End Youth Football Club

Players Full Name? *

First

Middle

Last

Players DOB?

Players Current Age?

Full Address?

Secondary Address? (Optional)

Parent/Guardian Full Name? *

First

Last

Contact Number (1)

Contact Number (2)

Medical History?

Do You Allow East-End F.C To Use Your Child In Any Photographic Material?

Yes
No

By signing this application form, i am acknowledging on behalf of myself, the organisation and the “players” that use of the East-End F.C facilities and the sport that my son/daughter will be participating with could cause a risk of injury. I give permission for the staff of East-End F.C to authorise necessary emergency medical treatment for my child in the event that I am not available to give such consent?

Yes
No

I also recognise that the individual coaches reserve the right to dismiss any participant detrimental to the overall good of the club without refund?

Yes
No
I don't understand

Data Protection – East-End F.C have a legal obligation to ensure that your data is safe, with us your privacy matters. We would ask that you tick the boxes below in which you would like to be contacted.

I consent to East-End Youth contacting me by post, phone or email.
To store my own and my child’s details securely as a registered member of East-End Youth
To keep me informed about news involving the club including events, training and any activities.

Parent Signature

Welcome To East-End Football Club