Senior Membership Form

- South Molton Football Club
  
  Senior Membership form 2022~2023 Season
- FAN

- First Name:*
- Last Name:*
- Date of Birth:*
  DD slash MM slash YYYY
- Home Address*
  Street Address Address Line 2 City State / Province / Region Postal ode Country
- Home Phone No
- Mobile Phone No*
- Email address:
- Do you have any known health needs? E.g. Diabetes, asthma, epilepsy, allergies.*
- If you do have health needs, what does the Club need to do to keep your child well e.g. administer medication / call ambulance / give snacks?*
- Do Club volunteers need any medical training other than First Aid to care for you?*
- 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
- 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
- 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.
- Signature :
- Date*
  DD slash MM slash YYYY
Choose plan*
Date
MM slash DD slash YYYY

A PLAYER WILL NOT BE REGISTERED UNTIL PAYMENT HAS BEEN MADE

SOUTH MOLTON AFC PARTNERS