Your Registration Data

 

 

Player Section

 

Team Age Group Under 10
First Name [44]
Surname [45]
Fan number if Registered N/A
Date of Birth 30th November 2015
Mobile Number N/A
Email [48]
Address

6 Lords Close
Post Code SE21 8JH
School Rosendale Primary School
School Post Code SE21 8LR
Previous Club Dulwich Hamlet Pink Under 9

 

 

Parents Section

 

Parent/Carer Parent
First Name [60]
Surname [61]
Date of Birth [126 format=”jS F Y”]
Fan number if Registered N/A
Mobile Number 07792 492112
Email lydie.olax@gmail.com
Address
Post Code

 

 

Medical Section

 

Does the player have any allergies or medical conditions YES
If so please state here

Allergy to RAW fruit and veg (Apple, Pear, orange, cucumber, carrot) Hay fever
Is the player taking medication YES
If so please state here

Antihistaminc
Is layer OK to administer medication unsupervised YES
If no, then suitable advice to be supplied to the team manager
Supply another emergency contact and number
First Name [77]
Surname [128]
Relationship to player Mother
Date of Birth 6th July 1974
Fan number if Registered N/a
Mobile number 07756 574077

 

 

Agreement and Confirmation Section

 

It is a condition of a player joining Dulwich Hamlet Junior FC that the player and parents, guardians, carers, family and supporters of that player, agree to be bound by the club rules and to abide by our club’s Code Of Conduct at all times.

A signing on fee of £50 is payable on completion of this form and can be paid using our secure online payments portal with Paypal which appear automatically when the registration form is submitted.

A fee of £8.00 is due weekly and is to be paid monthly – £32.00 – for a period of eight months only. This is to be set up at the same time as the signing on fee is completed using our secure online payment portal with Paypal.

Any subsequent brothers or sisters joining the club in the same season as players will be entitled to a £15.00 discount on the signing on fee.

Complete the payment boxes as usual for any siblings and on confirmation of that by the manager’s, the club will refund the difference direct to the person who made the payment.

Training – All training subs will be collected by the team manager and should never be paid direct to the club.

It is also a condition of joining the club that all club functions/fundraisers will be supported by all.

I agree to the conditions stated above and that all the information provided is correct. YES
11/06/2025
[60] [61]
(Parent of [44] [45])