Future Stars - Parental Consent Form

Welcome to Rainhill United Junior Football Club

Thank you for choosing to be part of our club. We hope you quickly feel part of the team and enjoy your time here Once you have filled this form in you will receive copies of key club policies. They are available to view here https://www.rainhillunited.co.uk/club-documents-4/ - These policies have been written so everyone in the club gets as much enjoyment out of grassroots football as possible.
Child's Full Name

First NameMiddle NameLast Name
Gender
School Year in September 2025
Date of Birth

DayMonthYear
Calculate Age
Address

Street Address

Street Address Line 2

City

Postcode
Additional Player Information
Name of School
Name of School if not on list:
Have you any other children at the club?
Other child Name:
Player Medical Information
Details of any known allergies, conditions, medication being taken.
Please insert NA if none known
Any other special needs, requirements or directions that manager needs to be aware of. NA if none
Please insert NA if none known
Does your child require glasses to play sport ?
GP Surgery Player is registered to (not doctor's name):
Name of GP Surgery if not on list:
Parent / Guardian Information
Contact 1 Name:

First NameLast Name
Contact 1 Relationship to Player:
Contact 1 Date of Birth:

DayMonthYear
New FA requirement need DOB of adults of U18 players
Contact 1 Mobile Number
Contact 1 E-mail:
Contact 2 Name (Alternative Emergency Contact):

First NameLast Name
Contact 2 Relationship to Player:
Contact 2 Date of Birth:

DayMonthYear
New FA requirement need DOB of adults of U18 players
Contact 2 Mobile Number
Photograph of Child (Passport style photo only - Head shot only)
Head shot only Photo Upload

Upload a File

Cancelof
Informed Consent and Acknowledgement
I will inform the manager of any important changes to my child’s health, medication or needs and also of any changes to our address or phone numbers provided.
In the event of illness, having parental responsibility for the above named child, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitably qualified medical practitioners. If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency medical treatment.
I confirm all details above are correct to the best of my knowledge and I am able to give parental consent for my child to travel to and participate in all activities.
I give permission for my child’s image to be used, as appropriate, on the Club Website and social media platforms under the guidance of FA directives on child protection.
Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Electronic Signature:
The Contents of this Submission are valid and correct for the 2025/2026 Season:
Signed by:
Your Relationship to Player:
Today's Date:

DayMonthYear
Date & Time of Original Consent Form Completion:

DayMonthYear
DateHourMinutes
Trainer Only
Left club
Leave Date

MonthDayYear
Date
Should be Empty:

Welcome to Rainhill United Junior Football Club

Additional Player Information

Player Medical Information

Parent / Guardian Information

Photograph of Child (Passport style photo only - Head shot only)

Informed Consent and Acknowledgement