Registration Form

Registration Form Download Link OPFC-RegForm2011.pdf

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 Old Parmiterians’ Football  Club 

 Website: www.oldparmiteriansfc.co.uk

CLUB REGISTRATION FORM   Season 2011-12

The data below is required by the Leagues & County Football Associations

All data supplied will remain confidential under the terms of the Data Protection Act

 

  • PLAYERS NAME:_________________________________________________________________

 

  • ADDRESS:______________________________________________________________________

________________________________________________________________________________

  

  • POSTCODE:_____________    EMAIL ADDRESS:________________________________________

 

  • TELEPHONE NUMBERS: HOME:_____________________________________________________

 

WORK:_____________________________MOBILE:____________________________________

 

OCCUPATION:________________________________________________________________

  

  • Date of birth:___________________                 Registration Fee for all members is £20

I agree to abide by the rules and codes of conduct of the Old Parmiterians Football Club and I agree

to play for the club for whichever team I am selected.

I am not under any suspension by another club or a county FA or owe monies to such bodies:

 

Other clubs currently playing for:_______________________________________________________

 

♦ Signed:_________________________________________Date:_______________________________

 

For New members only

 

Previous Clubs in Order:________________________________________________________________

  

Who Introduced you to the club:_______________________ Playing Position:___________________

 

This form should be sent to: Francis Mariani, 3 Waterhall Avenue, Chingford London E4 6NB 

Cheques for £20 should be made payable to Old Parmiterians FC

 

This form is required to determine who will be playing for the club this season and the number of teams we will field.

Any queries relating to this information can be addressed to me via email fpmariani@hotmail.com or

Tel: 07775 818138