Player Sign On 2023/24 (Form 1)

Team & Age Group *

Players Name *

First

Last

Players Full Address *

Players Date Of Birth DD/MM/YY *

Parent/Guardian Name *

First

Last

Parent / Guardian Date Of Birth DD/MM/YY *

Parent / Guardian FAN Number (FA No. if known)

Emergency Contact Number 1 *

Emergency Contact Number 2 *

Parent/Guardian Email *

Any Medical History That We Should Be Aware Of? *

Any Allergies? If YES please state *

Yes - please state below
No

Allergies

Does The Player Suffer From Diabetes? *

Yes
No

Any History Of Heart Disease In The Family, Parents & Grandparents? *

Yes - If yes please state below
No

Family Members With Previous Heart Disease? i.e. Mother

Does The Player Suffer From Epilepsy? *

Yes
No

Does The Player Suffer From Asthma Or Any Other Related Breathing Problems? *

Yes - If yes you need to provide your coach with an inhaler labelled with your childs name
No

Is The Player Taking Any Medication? *

Yes - If yes please state below
No

The Player Is Taking The Following Medication

Are There Any Other Medical Or Physical Conditions That We Need To Be Aware Of? *

Yes - If yes please state below
No

Medical or Physical Conditions

Do Runcorn Saxons FC Have Consent To Send The Player To Hospital If Required? *

Yes
No

I consent for the players photo to be used for Club PR and shared on social media. *

Yes
No

If you answered No, please give reason.

I confirm that I am aware of the FA’s Whistle-Blowing policy? *

Yes
No

I know who the Club Welfare Officer (CWO) is and how to contact them? *

Yes
No

By Submitting This Form You Are Granting Parental Agreement For Your Child To Participate In RSFC Football Activities. *

Please Type YES In The Above Box And Submit The Form.

Please complete and submit ALL 3 registration forms, starting with Form 1 below.

Player Sign On Form

Player FA Whole Game System / League Registrations will be conducted by the Club.

Runcorn Saxons FC use the FAs Matchday App to collect player subscriptions over 8 months between August – March.

Please download The Matchday App for your phone so that you are ready to go once your childs FA team and league registrations have been completed by the Club.

If you have any questions please contact your teams parent rep or email us