TikiTaca Futsal Club | Player Registration Form

PLAYER REGISTRATION

This form is to be completed by the Parent/Carer & signed by both Parent & Player(s). Parents/Carers are responsible in informing the club of any changes of details. On completion, please complete the Direct Debit Setup and Join the Club Community WhatsApp Group to receive all club notices.
No. of players registering:*
*For Multiple Players* - Please setup only one Direct Debit Instruction Form
On completion of this form I agree to:

To complete the Direct Debit SetupJoin the Club Community Group via WhatsApp
Would you be interested in 1-1 Sessions?*
If selected yes, we will be in touch with further details
Select Location*

PLAYER DETAILS
Player Name*

First NameLast Name
Date of Birth*

DayMonthYear
Current Age*
Age at the start of club registration
Current Year*
Current Year at School
Futsal Position*
Please select preferred position
Futsal Experience?*
Has the player played Futsal before?
Player Jersey Size:*
Please select jersey size (If unsure, request to try on)
Player Initials:*
Initials for Training Jersey
Health & Allergies

Please fill the section fully as possible, failure to do so may compromise the safety and welfare of your child.
Does your child have any known health needs? e.g asthma, diabetes, epilepsy, allergies *
If yes, please complete section below
Please specify health condition below and any specific medical requirements/medical training other than First Aid to assist
I agree to the club holding the health, medical and/or medication data I have provided below to ensure my child’s safety and to take appropriate action to ensure their wellbeing.*

I Agree

PLAYER DETAILS #2
Player Name*

First NameLast Name
Date of Birth*

DayMonthYear
Current Age*
Age at the start of club registration
Current Year*
Current Year at School
Futsal Position*
Please select preferred position
Futsal Experience?*
Has the Player played Futsal before?
Player Jersey Size:*
Please select jersey size (If unsure, request to try on)
Player Initials:*
Initials for Training Jersey
Health & Allergies

Please fill the section fully as possible, failure to do so may compromise the safety and welfare of your child.
Does your child have any known health needs? e.g asthma, diabetes, epilepsy, allergies *
If yes, please complete section below
Please specify health condition below and any specific medical requirements/medical training other than First Aid to assist
I agree to the club holding the health, medical and/or medication data I have provided to ensure my child’s safety and to take appropriate action to ensure their wellbeing*

I Agree

IMAGES/VIDEOGRAPHY CONSENT
The club may wish to take photos or videos of the team or individuals. As per The FA Guidelines, these will be used solely for promotion and celebration of the activities of the club and for training purposes.*

I agree to the club being able to take photos and videos during this season of my child. I understand that I can withdraw my consent for this at any time during the season by notifying the club.

PERMISSION OF PARENT/GUARDIAN
Terms and Conditions*
Code of Conduct*
Player Profile Image(s)*

Please upload a player(s) profile photo for identification
Cancelof
Signature*

Clear
Date of Signature

DayMonthYear
Should be Empty:

PLAYER REGISTRATION