CYC Summer Camp Registration Form

CYC Football Community Registration
Player Information
Player's Name

First NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Asian or Asian British

Other
Black, Black British, Caribbean or African

Other
Mixed or multiple ethnic groups

Other
White

Other
Other ethnic group

Other
Activity
Parent/Guardian Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: 0000-000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: 0000-000-0000.
Does the player have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the player prescribed an inhaler? If yes, please explain any instructions.
Would You Like To Be Add To CYC WhatsApp Group?
Please confirm that you give consent for any photos / video taken in the sessions can be uploaded on to the social media and website of Can You Challenge F.C!
Date

DayMonthYear
Date
Signature
Should be Empty:

CYC Football Community Registration