Register - LEFC

LEFC Membership Registration Form 2018-19

Please complete and submit a form per child

Player Name

Player’s date of birth

School year (from September 2018)

Any medical conditions the club should be aware of e.g. asthma

Home address and post code

Parent or Guardian contact information

Full name

Email address

Mobile number

2nd Parent or Guardian contact information (Optional)

Full name

Email address

Mobile number

Emergency Contact information

Full name

Mobile number

Player agreement

I agree to be bound by and observe the Club Rules and FA Respect Code of Conduct, the Rules and Regulations of the Football Association Ltd., Leics & Rutland FA and all competitions in which the Club participates. Link to the Respect Code
Player Agreement

Parental consent

I/we understand and accept that football can involve injury and agree that the Club cannot be held liable or responsible for any injury sustained whilst my son/daughter is playing for the Club/travelling to and from football events. In the event that my son/daughter is injured whilst playing football/travelling to and from football events and I/we cannot be contacted on the above number, I hereby give my consent for my child to receive medical attention. I/we agree to be bound by the Club Rules and FA Respect Code of Conduct. I/we agree to payment in full of all registration, training and match fees, together with any fines levied on our child.
Parental/Guardian Consent

I/we are happy for our child’s (unnamed) image to appear in club publicity material and/or the end of season presentations.

Parental/Guardian Consent (club publicity)