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 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 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
- Parent/Guardian Name*
- Relation to Player*
- E-mail*
- Contact Number*
  
  Area CodePhone Number
- Address*
  
  House Number & Street Address
  
  Street Address Line 2
  
  City
  
  Post CodeCountry
- My Products
  Categories:All
  
  All
  
  Single Player Membership
  
  Siblings Membership
  
  prevnext( X )
  
  Single Player Membership
  
  Standard Futsal Membership (Per Month)
  Membership will cover x1 session per week - (£50 Club Registration Fee will be added to the first payment. Includes full training kit)
  
  £40.00
  
  
  
  Pro Futsal Membership (Per Month)
  Membership will cover x2 sessions per week - (£50 Club Registration Fee will be added to the first payment. Includes full training kit)
  
  £45.00
  
  
  
  Elite Futsal Membership (Per Month)
  Membership will cover x3 sessions per week - (£50 Club Registration Fee will be added to the first payment. Includes full training kit)
  
  £50.00
  
  
  
  Siblings Membership
  
  Sibling - Pro Futsal Membership (Per Month) - 10% Discounted
  Membership will cover both siblings x2 sessions per week - (£100 Club Registration Fee will be added to the first payment. Includes full training kit)
  
  £81.00
  
  
  
  Sibling - Standard Futsal Membership (Per Month) - 10% Discounted
  Membership will cover both siblings x1 session per week - (£100 Club Registration Fee will be added to the first payment. Includes full training kit)
  
  £72.00
- *Please note: Sessions are subject to change for 2025/26*
- (U4-U6) - Available Session(s) - (Standard Membership)
  
  (U4-U6) Saturday 9am - 10am - Uxbridge High School
- (U6-U9) - Available Session(s) - (Standard Membership)
  
  (U7/U8/U9) Wednesday 6pm - 7pm - Oakwood School (INVITE ONLY)(U6/U7/U8) Saturday 10am - 11:30am - Uxbridge High School(U6/U7/U8) Sunday 10am - 11:30am - Swakeleys High School
- (U6-U9) - Available Session(s) - (Pro/Elite Membership)
  
  (U7/U8/U9) Wednesday 6pm - 7pm - Oakwood School (INVITE ONLY)(U6/U7/U8) Saturday 10am - 11:30am - Uxbridge High School(U6/U7/U8) Sunday 10am - 11:30am - Swakeleys High School
- (U9-U10) - Available Session(s) - (Standard Membership)
  
  (U9/U10) Wednesday 7pm - 8:30pm - Oakwood School (INVITE ONLY)(U9+) Sunday 11:30am - 12:30pm - Swakeleys High School
- (U9-U10) - Available Session(s) - (Pro/Elite Membership)
  
  (U9/U10) Wednesday 7pm - 8:30pm - Oakwood School (INVITE ONLY)(U9+) Sunday 11:30am - 12:30pm - Swakeleys High School
- (U10-U12) - Available Session(s) - (Standard Membership)
  
  (U10/U11/U12) Thursday 6pm - 7:30pm - Oakwood School (INVITE ONLY)(U9+) Sunday 11:30am - 12:30pm - Swakeleys High School
- (U10-U12) - Available Session(s) - (Pro/Elite Membership)
  
  (U10/U11/U12) Thursday 6pm - 7:30pm - Oakwood School (INVITE ONLY)(U9+) Sunday 11:30am - 12:30pm - Swakeleys High School
- (U12-U14) - Available Session(s) - (Standard Membership)
  
  (U12/U13/U14) Thursday 7:30pm - 9pm - Oakwood School (INVITE ONLY)(U9+) Sunday 11:30am - 12:30pm - Swakeleys High School
- (U12-U14) - Available Session(s) - (Pro/Elite Membership)
  
  (U12/U13/U14) Thursday 7:30pm - 9pm - Oakwood School (INVITE ONLY)(U9+) Sunday 11:30am - 12:30pm - Swakeleys High School
- (U14-U16) - Available Session(s) - Standard Membership
  
  (U14//U15/U16) Friday 7:30 - 8:30pm - Lampton High School
- Please select first training start date:*
- 12th of the Month22nd of the Month
- 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.
- Terms and Conditions*
- Code of Conduct*
- Player Profile Image(s)*
  
  Please upload a player(s) profile photo for identification
  Cancelof
- Signature*
- Date of Signature
  
  DayMonthYear
- Should be Empty:

PLAYER REGISTRATION

Health & Allergies

Health & Allergies