Junior Membership Form

- Please only fill this form in if you have had contact with someone at the football club to confirm age group availability. You can contact us through our Facebook page. (Top Right)

- South Molton Football Club
  
  Junior Membership Form 2020~2021 Season
- Age Group*
- FAN
- Manager's Name*

- Name of Child:*
- Child's Date of Birth:*
- School Year:*
- Name of Parent/Guardian :*
- Parent's Date of Birth or Parent's FAN*
- Home Address*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Home Phone No*
- Parent/Guardian's Mobile:*
- Parent/Guardian's Email(s):*
- If this is registration for a brother or sister of another South Molton player please add their name and age group.
- Does your child have any known health needs? E.g. Diabetes, asthma, epilepsy, allergies.*
- If your child does have health needs, what does the Club need to do to keep your child well e.g. administer medication / call ambuance / give snacks?*
- Do Club volunteers need any medical training other than First Aid to care for your child?*
- At times the Club may wish to take photos or videos of the teams or individuals in them. We adhere to The FA Guidelines to ensure these are safe and respectful and used solely for the purposes for which they are intended, which is promotion and celebration of the activities of the Club and for training purposes. The images may be published on the Club's website, Facebook Pages, YouTube Channel and in the local press. Please circle Yes if this is acceptable or circle No if it is not.*
  - Yes
  - No
- The club uses a Facebook page to communicate with parents/guardians. Children over the age of 13 may use Facebook, but FA guidance requires us to get your permission before allowing U18's access to our Facebook Pages. If your child is over 13, please indicate if it is acceptable to you for your child to 'like' the Club's Facebook page. Please circle Yes if it is acceptable or circle No if it is not. If you indicate No, we will use Facebook's settings to ban your child from liking & commenting on our pages.*
  - Yes
  - No
- Please upload a player photo here (Head and shoulders only)*
- The FA require every player to be registered with them. This requires a passport style photo to be uploaded onto their FA registrations Website and The FA's Whole Game System. A new photograph needs to be uploaded at the start of every season. A photo is essential - The FA do not allow a player to play football without one. In the photo you must: be facing forwards and looking straight at the camera. have a plain expression and your mouth closed. have your eyes open and visible. not have hair in front of your eyes. not have a head covering (unless it's for religious or medical reasons) not have anything covering your face.
- We all have a responsibility to promote high standards of behaviour in the game. This club is supporting the FA's Respect programme to ensure football can be enjoyed in a safe, positive environment. Remember, children's football is a time for them to develop their technical, physical, tactical and social skills. Winning isn't everything! By signing and returning this form you are confirming that you and your child have read, and will conform to, the attached Code of Conducts for Young Players and Parents/Guardians/Spectators
- By signing and returning this membership form, you are committing to paying the club's membership fees. Please speak to us about concessionary membership if you feel you need to. Cases for concessionary membership will be dealt with in confidence. In circumstances of non-payment of membership fees by the due dates where there has been no contact with the Club to discuss concessionary membership then players will not be able to continue training with the club or to play in matches.
- Parent / Guardian Signature:
- Date*
  Date Format: DD slash MM slash YYYY
- *
  COVID-19
  I consent for my child to take part in all football club actives and I have read and understood the activities being offered to your child and agree with the measures the club has put in place tomanage any risks, including its Covid-19 measures in line with current Government guidance. MEMBERSHIP DOCUMENTS COVID-19
  - Yes
  - No
Choose plan*
If you are paying by BACS please see the following payment detail

Sort Code: 55-50-29
Account Number 61084603
Please use your child's age group and surname as a reference – eg. U14GERRARD.--

SOUTH MOLTON AFC PARTNERS