Mini Meads Membership Form 2020/21

Step 1 >

1). Have you previously been registered with another team in Wiltshire (including FC Abbey Meads)?*:

Please Choose:YesNo

If NO, you will need to provide a photo copy of proof of age (ie birth certificate, passport). Please use the button below to upload this to us:

2). Does the player have a sibling already playing for FC Abbey Meads*?

NoYes

If Yes, please enter their name(s) and teams(s) below:

Step 2 >

Player Details

First Name*:

Middle Name(s):

Last Name*:

Gender*: FemaleMale

Date of Birth*:

Telephone Number:

Email Address:

FAN Number (if known):

Address 1*:

Address 2:

Town*:

County*:

Postcode*:

Step 3 >

Parent/Guardian Details

First Name*:

Last Name*:

Parent FAN Number (if known):

Parent Date of Birth*:

Mobile Number*:

Home Number:

Email Address*:

Address 1*:

Address 2:

Town*:

County*:

Postcode*:

Step 4 >

Medical Information

Doctor's Name:*:

Doctor's Surgery Name*:

Doctor's Telephone Number*:

Allergies/Special Health Considerations (if none please put N/A)*:

Emergency Contact 1 Name*:

Emergency Contact 1 Telephone Number*:

Emergency Contact 1 Alternative Number:

Emergency Contact 2 Name:

Emergency Contact 2 Telephone Number:

Emergency Contact 2 Alternative Number:

Step 5 >

Declaration & Terms

I agree to be bound by and to observe FC Abbey Meads Rules and the Rules and Regulations of The Football Association and all Competitions in which the Club participates. I have read and agree to abide by FC Abbey Meads Constitution, Codes of Conduct, GDPR and all other policies FC Abbey Meads have in place (all of which can be viewed at www.fcabbeymeads.co.uk or a hard copy upon request). From this year forward we will not accept any other payment method than the above unless by prior arrangement with the club treasurer.

Terms: Should your child exit the club during the calendar year (August – May) all subs shall be paid up to the date of transfer or exit plus one month to cover administrative costs. Should your payments have fallen into arrears prior to exit or transfer the club (FCAM) reserve the right to withhold a transfer request until such a time arrears are cleared and report the debt to Wiltshire County FA. In the event of exiting the club where arrears are outstanding the club, (FCAM) reserve the right to inform Wiltshire County FA / and or a debt collection agency, which could affect your child’s ability to sign for a future club. Also on exit or transfer all FCAM property is to be returned or the above action will be applied.

Tick here to accept*: I accept

Discipline

Booking of and/or sending off of a player incurs a fine levied by the FA. It is the responsibility of the parent/guardian of the player concerned to refund the Club for payment of these fines. Failure can result in the player being suspended indefinitely.

Tick here to accept*: I accept

No pay no play policy

Under the Club’s insurance arrangements, players are only covered if their membership fees are paid up. As a result, the Club reserves the right to not allow a player to train with or play for the Club where their membership fees are due and owing.

Tick here to accept*: I accept

Team Kit

The Purple/Blue/Orange/Grey team strips (shirts, shorts, socks, jackets, jumpers) are all bought under a club contract through sponsorship or parental contribution and remain the property of FC Abbey Meads at all times. They must be returned to team coaches when a player leaves the club or grows out of it. The kit can only be used for FCAM purposes and needs to be kept in good condition, accepting fair wear and tear. Also, whilst our intention is to issue a kit/shirt number for each player for the whole season wherever we can, if a team is short we may need to take kits back/rotate after matches or from time. If lost or damaged, replacement kits (or items) will need to be paid for. Failure can result in player Suspension from joining other clubs and playing.

Tick here to accept*: I accept

Photography/Promotion Consent

There may be occasions whilst playing for FC Abbey Meads, the players merit local press coverage to appear in the Evening Advertiser, Link magazine, Social media etc. Additionally we have a website and would like to use photos of the players in this. However, before we could allow photographs to be taken of your child for this type of activity, we require your parental consent. We would always try to keep you notified of such instances, but these occasions do tend to occur without much notice given. Please therefore could you complete the reply slip below which we would keep on file to advise us of your wishes should the need arise in future.

Tick here to accept*: Yes I do consentNo I do not consent

Medical Consent

I authorise all medical and surgical treatment, X-ray, laboratory, anaesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending doctor and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the even that neither parent/guardian can be reached in the case of an emergency.

Tick here to accept*: I accept

Tournaments/Other Organised Activities

I give permission for my child to attend tournaments and other activities organised by FC Abbey Meads. I release FC Abbey Meads and individuals from liability in case off accident during activities related to FC Abbey Meads, as long as normal safety procedures have been taken.

Tick here to accept*: I accept

Privacy Policy

I have read and understood FC Abbey Meads Privacy Policy. A copy of this can be found by clicking here

Tick here to accept*: I accept

RESPECT Code of Conduct - Players

I have read and understood the FA's RESPECT Code of Conduct for players and agree to be bound by it. A copy of this can be found by clicking here

Tick here to accept*: I accept

RESPECT Code of Conduct - Spectators/Parents

I have read and understood the FA's RESPECT Code of Conduct for spectators/parents and agree to be bound by it. A copy of this can be found by clicking here

Tick here to accept*: I accept

Players Signature*
(Use your mouse/pointer on a laptop/PC or your finger on mobile or iPad devices):

Parent/Guardian Signature*
(Use your mouse/pointer on a laptop/PC or your finger on mobile or iPad devices):