For Each Registered Player Under 18, the Berks & Bucks FA Requires a Parent Or Guardian

/ Woodley Saints Football Club – Parent/Guardian Consent Form
2017-2018 /

For each registered player under 18, the Berks & Bucks FA requires a parent or guardian to provide the

information below and to sign the declaration. Please return the completed form to your child’s team manager.

Player’s name: / Date of Birth:
Parent/Carer’s name: / Contact Numbers:
Contact email(s):
House No./Name: / Postcode:
School:

Please provide details of any medication, ailments, allergies or other information that we need to be aware of in case of an emergency. Please also make us aware of any changes. You are not obliged to provide details but it may help your child in an emergency. Only your manager will be privy to this form and the information will not be shared with anyone other than the emergency services. Continue on a separate sheet if necessary.

Note that the club carries Public Liability and (limited) Personal Accident insurances on behalf of all the players, managers and other club officials. If you want to increase the PA cover, this is a private matter and details of suitable policies are available for example from localschools.

Declaration:

I agree to my child taking part in matches, training and other activities organised by Woodley Saints FC.

I agree to my child receiving medication as instructed, and any emergency dental, medical or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medical authorities present.

• I have read and understood the above notes, and the information I have given is complete and correct to the
best of my knowledge.
• I confirm that the Manager/Coach of my child’s squad has delivered the “FA Respect” message and that I
understand and will fully conform to these FA guidelines
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I confirm that I must bring to the attention of the manager if I do not agree to photographs being taken of my child during games when playing for Woodley Saints FC in line with FA guidelines available on the club website.

I understand and accept that, irrespective of the source, all issued club kit remains the property of the club and must be handed in if my child leaves the club.

I understand and accept that parents/guardians are not allowed to help with direct involvement in training or match activities without being CRB checked and, to avoid the risk of injuries, must not under any condition take an active role in practice play with the children as part of Woodley Saints FC activities.

I understand and accept that I will be obliged to help with various duties as designated on the day(s) of the club’s annual tournament and that if I don’t my child will not be eligible to play in the event.

Signed: Dated: ____/____/____