Bradley Stoke Youth Football Club
Membership Form
Player's Name: ................................................................................................................................
Date of Birth: ................../..................../..................
Address: ...............................................................................................................................
...............................................................................................................................
Telephone (Home): ...............................................................................................................................
Telephone (Mobile): ...............................................................................................................................
Current Club (if any): ...............................................................................................................................
Football Academy (if any): ...............................................................................................................................
School: ...............................................................................................................................
Year Group: ...............................................................................................................................
Doctor: ...............................................................................................................................
Telephone No: ...............................................................................................................................
Date of last Tetanus Injection: ................../..................../..................
Alergies/medical conditions: ...............................................................................................................................
...............................................................................................................................
(hay fever, plasters, medicines etc. Written medical instructions must be provided if your child needs medication)
Parent/Guardians Name: ...............................................................................................................................
Declaration
I have read & agree to abide by the Club Code of Conduct.
Signed: ........................................................... Player
Signed: ........................................................... Parent/Guardian
Signed: ........................................................... Manager
Date: ..........................
Bradley Stoke Y.F.C has Public Liability Insurance arranged through the G.Y.F.A