Canvey Island Youth Football Club

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date Of Birth *

MM

DD

YYYY

Parent / Guardian Details *

First Name

Last Name

Mobile *

(###)

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Parent / Guardian Details *

First Name

Last Name

Mobile *

(###)

###

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PHOTO CONSENT: *

At times the Club may wish to take photos or videos of the team or individuals in it. 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. Please indicate if this is acceptable to you:

Yes

No

Whole Game System *

The FA Whole Game System is a new online Player Registration system, players registration details and photos are uploaded to the FA Secure Data Base. By signing below you are giving consent to this. I declare that I and registered player above have read the FA Code of Conduct and agree to abide by these. I acknowledge that the home kit belongs to Canvey Island Youth and must be returned at the end of the season or if the player decides to leave the team.

I accept