STAFFORDSHIRE LADSANDADS CLUB

League Entry Registration Form Season 2019/20 Under 14s

Last Registration Date Friday 26th July 2019 @ 20:00

If you require any help or assistance please email info@nsjyl.com

Club Name:
Full Team Name:
Age Group:
Branch:
F.A. Affiliation Num:

Manager Details
Full name:
Address:
Postcode:
Telephone Number(s):

(mobile)

(home)

Email Address (also used for updates from Full Time):
DBS (CRB) Number:
DBS (CRB) Issue Date:

CLUB SECRETARY
Full Name & address as on FA Affiliation Form:
Postcode:
Telephone Number(s):

(mobile)

(home)

Email Address:

MATCH DAY SECRETARY (if applicable)
Full Name:
Address:
Postcode:
Telephone Number(s):

(mobile)

(home)

Email Address:

ASSISTANT MANAGER
Name:
Telephone Number(s):

(mobile)

(home)


CLUB WELFARE OFFICER
Full Name & address:
Postcode:
Email Address:
Contact Number:

FAN Number:
   
First Aider Details (if known):
Full address of home ground:
Postcode:
Club Colours:

HOME

 

(shirts)

(shorts)

(socks)

AWAY

Please tick box if same as home

(shirts)

(shorts)

(socks)

Password:(Please keep safe. Used to login into Manager Login page)  

By submitting your registration, you agree to our privacy policy and acknowledge we may use the contact details provided to be used on this website and Full Time for teams to contact you about arranging football matches. This may include post, phone, email and SMS.

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