Chester FC Boys PDC Expression of Interest 2023

1
Player Name* This field is required.Please provide the player's full name.
First Name
Last Name
2
Date of Birth* This field is required.The player's date of birth.
Date
Day
Month
Year
3
Age GroupPlease select the relevant age group based on 2022/23 season bandings.
U7s
U8s
U9s
U10s
U11s
U12s
U13s
4
Responsible Adult* This field is required.Please provide the name of a parent or responsible adult for the above child.
First Name
Last Name
5
Emergency Contact Number* This field is required.Please provide a contact mobile number for the responsible adult in case of emergenices.
Area Code
Phone Number
6
Email* This field is required.Please provide a contact email address for the responsible adult.
example@example.com
7
Current Club or Development Centre* This field is required.Players continue to train and play for their grassroots team as the PDC does not impact on existing commitments.
8
Position* This field is required.Please list the player's preferred positions.
9
Medical InformationPlease detail any allergies or medical conditions coaches may need to be aware of.
10
Photographic Consent* This field is required.Do you consent to Chester FC Community Trust photographing or videoing the above child’s involvement in activities to publicise or promote the charity or as a coaching aid?
YESNO
Should be Empty: