Downley Dynamos Football Club - Player Registration form 2017/18 Season

Please fill in the below registration information, * is a required field and must be entered.

Player Information

Player First Name:
*
Player Last Name:
*
Date of Birth: (dd/mm/yyyy)
*
Age Group:
*
School Attended:
*
School Year:
*
Home Address 1:
*
Home Address 2:
City:
*
County:
Post Code:
*
Other Siblings at Downley Dynamos (Name & Age group):

Parent/Guardian Information

Parent/Guardian Name: *
Telephone Home:
*
Telephone Mobile:
Contact E-mail Address (for team selection,fixtures,cancellation etc.): *
Alternative Contact Name: *
Telephone Home:
*
Telephone Mobile:

Medical Information

Do you consent to emergency First Aid being given to your child?:
*
Is your chid allergic to sticking plasters?:
*
Does your child have any other allergies or medical conditions?:
*
If YES, then please provide details and any medication required:

Subscriptions

Please select subscription payment:

Once your registration has been submitted you will receive an email notification with a link to the Downley Dynamos payment portal to complete payment over the next few days

Match Fees 2017/18

U7 - U11 - ₤2.00 (per match)

U12 - U18 - ₤2.00 (per match)


:
Signature (parent/guardian)
Please Type full name:
*
Date: (dd/mm/yyyy)
*